Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MRS. MIRANDA R DETHIER, PA-C
ActiveMRS. MIRANDA R DETHIER, PA-C is a Physician Assistant healthcare provider located in JEFFERSON, Wisconsin. NPI 1760770960 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · JEFFERSON, WI
Registration Details
- NPI Number
- 1760770960
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 21, 2011 (15.058498018654 yrs)
- Last Updated
- May 3, 2017
- License
-
2758-23 (WI)
Practice Information
- Address
-
840 W RACINE STJEFFERSON, WI, 535491053Browse WI providers · Browse ZIP 53549
- Phone
- 9206746000
- Fax
- 9206743034
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in JEFFERSON, WI
| Name | Credential | NPI |
|---|---|---|
| CHERYL A KOLKOVICH | PA-C | 1326045485 |
| LAURA A HUEBEL | P.A. | 1912986209 |
| KASTYN ALICE HEBBE | — | 1356074561 |
| EMILY BORKOWSKI | — | 1851121842 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.