Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD.10642R | LA |
N | 2080A0000X | Adolescent Medicine | 10642R | LA |
NPI | 1144221292 |
---|---|
Provider Name | Dr. Amy L. Miller |
First Address | New Orleans, LA 70121-2429 |
Second Address | New Orleans, LA 70121-2406 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2005 |
Last Update Date | 14/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01853361 | (05) | MS |
1993654 | (05) | LA |