MIRANDA SAM
NPI 1639957624
Specialist in Sartell, MN

Q: What is the provider's specialty?

The provider's specialty is Specialist with taxonomy code 174400000X.

Active since September 20, 2023

1801 AMBER AVE S, SARTELL, MN 56377(218) 287-4338 Get Directions Write a Review

NPPES record last updated: September 20, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

On this page

About Miranda Sam NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MIRANDA SAM (NPI 1639957624) is an individual specialist in Sartell, Minnesota and active in the NPI registry since September 2023.

NPPES Registry Identity

NPI1639957624

Entity TypeIndividualFemale

Primary Taxonomy174400000X

Provider Legal NameMIRANDA SAM

Location Address1801 AMBER AVE SSartell, MN 56377-7507

Mailing Address1547 30th Ave SMoorhead, MN 56560-5149

Phone(218) 287-4338

Sole ProprietorNo

Enumeration DateSeptember 20, 2023

NPPES CertifiedSeptember 20, 2023

✔ NPI 1639957624 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

Definition

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

1801 AMBER AVE S, Sartell, MN 56377

Open in Google Maps ↗

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHANNON KUMMROW

Specialist