Provider Demographics
NPI:1144490194
Name:KLINNER, MIRANDA RENEE (CPM)
Entity type:Individual
Prefix:MRS
First Name:MIRANDA
Middle Name:RENEE
Last Name:KLINNER
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18106 STONE ANGEL DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3502
Mailing Address - Country:US
Mailing Address - Phone:281-319-6262
Mailing Address - Fax:281-852-6114
Practice Address - Street 1:503 N AVENUE H
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3850
Practice Address - Country:US
Practice Address - Phone:281-319-6262
Practice Address - Fax:281-852-6114
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX99017176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife