Provider Demographics
NPI:1255216354
Name:MIRANDA, LINDA STEPHANIE
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:STEPHANIE
Last Name:MIRANDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:MIRANDA
Other - Last Name:KIRCHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1111 SILVA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95404-2900
Mailing Address - Country:US
Mailing Address - Phone:512-560-4142
Mailing Address - Fax:
Practice Address - Street 1:1111 SILVA AVE
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95404-2900
Practice Address - Country:US
Practice Address - Phone:512-560-4142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-07
Last Update Date:2025-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula