Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP07322 | LA |
N | 363LA2200X | Nurse Practitioner - Adult Health | AP07322 | LA |
N | 363LG0600X | Nurse Practitioner - Gerontology | AP07322 | LA |
N | 363LP2300X | Nurse Practitioner - Primary Care | AP07322 | LA |
NPI | 1013355148 |
---|---|
Provider Name | Cynthia Reed Miller |
First Address | New Orleans, LA 70121-2429 |
Second Address | Baton Rouge, LA 70816-3246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/06/2013 |
Last Update Date | 17/05/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
312031YJA2 | MEDICARE (01) |