Provider Demographics
NPI:1437984986
Name:BYRD, MIRANDA LIEL (RN, BSN, CLC, IBCLC)
Entity type:Individual
Prefix:
First Name:MIRANDA
Middle Name:LIEL
Last Name:BYRD
Suffix:
Gender:F
Credentials:RN, BSN, CLC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 CLEARVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-2703
Mailing Address - Country:US
Mailing Address - Phone:585-797-8243
Mailing Address - Fax:
Practice Address - Street 1:135 CLEARVIEW DR
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-2703
Practice Address - Country:US
Practice Address - Phone:585-797-8243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-04
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY603355163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant