Doctor Name: | JENNIFER SUE MILLER |
NPI Number: | 1043370745 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA - C |
License Number: | MA002450L |
Business Practice Address: | 312 Industrial Park Rd Meyersdale, PA - 155527290 |
Business Phone Number: | 8146345954 |
Business Fax Number: | 8146349187 |
Mailing Address: | 312 Industrial Park Rd, MEYERSDALE |
State: | PA |
Postal Code: | 155527290 |
Phone Number: | 8146345954 |
Fax Number: | 8146349187 |
NPI Enumeration Date: | 12/11/2006 |
NPI Last Update Date: | 05/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | MA002450L |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | PA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |