| Doctor Name: | MR. BRUCE EVERETT MILLER |
| NPI Number: | 1003876012 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 9169 |
| Business Practice Address: | 4801 Veterans Dr Saint Cloud, MN - 563032015 |
| Business Phone Number: | 3202556480 |
| Business Fax Number: | |
| Mailing Address: | 416 12th St N, SARTELL |
| State: | MN |
| Postal Code: | 563771407 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 9169 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |