Miranda Winifred Rifenburgh, MSN, AGPCNP-BC, CWS
Nurse Practitioner, Primary Care in El Segundo, CA. Individual provider (NPI-1).
NPI number1164073755
StatusActive
Last updated in NPPESJan 5, 2023
Details
- NPI
- 1164073755
- Entity type
- Individual (NPI-1)
- Name
- Miranda Winifred Rifenburgh
- Credential
- MSN, AGPCNP-BC, CWS
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 25, 2019
- Certification date
- Jan 5, 2023
- Last updated
- Jan 5, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP2300X | Nurse Practitioner, Primary Care | 95012259 | CA | Yes |
Practice location
222 N Pacific Coast Hwy Ste 1420El Segundo, CA 90245-5648
Phone 818-318-2530
Mailing address
5818 E Lanai StLong Beach, CA 90808-3814
Phone 818-318-2530
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