Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN.CNP.019601 | OH |
NPI | 1013464080 |
---|---|
Provider Name | Kristie Elizabeth Miller |
First Address | Youngstown, OH 44505-1012 |
Second Address | Youngstown, OH 44505-1012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2016 |
Last Update Date | 28/07/2017 |