Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 26510 | TN |
NPI | 1003815283 |
---|---|
Provider Name | Kristin M. Miller |
First Address | Germantown, TN 38138-7438 |
Second Address | Memphis, TN 38138-7438 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/07/2005 |
Last Update Date | 08/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G00878 | (02) | TN |