Provider Demographics
NPI:1053947663
Name:GRECO, MIRANDA DANIELLE (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:DANIELLE
Last Name:GRECO
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8007 SUSPIRO DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77083-5025
Mailing Address - Country:US
Mailing Address - Phone:832-768-1446
Mailing Address - Fax:
Practice Address - Street 1:13902 FORT NELSON DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77083-6480
Practice Address - Country:US
Practice Address - Phone:832-768-1446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-15
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily