Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | APRN51341 | WV |
N | 363LF0000X | Nurse Practitioner - Family Medicine | APRN51341 | WV |
NPI | 1487202826 |
---|---|
Provider Name | Jodi Lynn Miller |
First Address | Wheeling, WV 26003-4161 |
Second Address | Wheeling, WV 26003-4161 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2019 |
Last Update Date | 13/12/2021 |