Doctor Name: | JESSICA D MILLER |
NPI Number: | 1295986131 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | 335709 |
Business Practice Address: | 8550 State Highway 28 Richfield Springs, NY - 134394830 |
Business Phone Number: | 3158580040 |
Business Fax Number: | 3158580075 |
Mailing Address: | Po Box 725, COOPERSTOWN |
State: | NY |
Postal Code: | 133260725 |
Phone Number: | 3158580040 |
Fax Number: | 3158580075 |
NPI Enumeration Date: | 10/09/2008 |
NPI Last Update Date: | 10/09/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 335709 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |