| Doctor Name: | MRS. TINA RENA MILLER |
| NPI Number: | 1407195159 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSN APRN NP-C |
| License Number: | 17269 |
| Business Practice Address: | 8510 Wilkinsville Rd Suite 104 Millington, TN - 380531537 |
| Business Phone Number: | 9018723114 |
| Business Fax Number: | 8558169602 |
| Mailing Address: | 8510 Wilkinsville Rd, Suite 104 MILLINGTON |
| State: | TN |
| Postal Code: | 380531537 |
| Phone Number: | 9018723114 |
| Fax Number: | 8558169602 |
| NPI Enumeration Date: | 01/31/2013 |
| NPI Last Update Date: | 04/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 17269 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |