| Provider / Organization | NPI | Date Certified |
|---|---|---|
| MIRANDA EBNER | 1417320276 | 2022-09-17 |
Miranda Ebner is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1417320276. Registration indicates Miranda Ebner is a provider of services with a specialization in Dietary & Nutritional Service Providers, Nutritionist (Nutritionist, ) (All Other Specialties & Provider Types, ) (Nutritionist, Dietary & Nutritional Service Providers)
| Entity Type | Individual |
| Provider Name | Miranda Ebner LN |
| Practice Office Address | 5739 GARFIELD AVE MINNEAPOLIS, MN US |
| Practice Office Telephone | 6124402415 |
| Mailing Address | 5739 GARFIELD AVE MINNEAPOLIS, MN 554191715 US |
| Business Telephone | 6124402415 |
| Code | Practice | License No State |
|---|---|---|
| 133N00000X PRIMARY | Dietary & Nutritional Service Providers Nutritionist Nutritionist All Other Specialties & Provider Types Nutritionist Dietary & Nutritional Service Providers | N217
MN |