Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Miranda Reshae Bostic, PMHNP-BC

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1346668050

Miranda Reshae Bostic, PMHNP-BC is a Nurse Practitioner in Portland, Oregon. Qualified in 2019, 7 years ago. Practices with Mindful Therapy Group PC, a 646-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Oregon and Tennessee.

Years since qualifying
7
Licensed in
OR, TN
In the registry since
2014
Specialties on file
3
What do these letters mean?
PMHNP-BC — Psychiatric-Mental Health Nurse Practitioner, Board Certified
A board-certified psychiatric nurse practitioner.

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Practice location Address checks out

5441 S Macadam Ave Ste A
Portland, OR 97239-3822
Phone: (541) 248-1204
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2018 Western Ave, Knoxville, TN 37921-5718 — (865) 544-0406

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 10042383 (OR)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 26208 (TN)
Nurse Practitioner Taxonomy 363L00000X · Licence 26208 (TN)

Record details

NPI number1346668050
Entity typeIndividual (Type 1)
GenderFemale
Credentials PMHNP-BC
Sole proprietorNo
NPI enumeratedMarch 31, 2014
Last updated in NPPESSeptember 18, 2025
Certification dateSeptember 18, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Mindful Therapy Group Pc — 646 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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