Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 28330 | TN |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 113288 | NE |
NPI | 1497362297 |
---|---|
Provider Name | Madison Miller |
First Address | Nashville, TN 37204-4701 |
Second Address | Nashville, TN 37232-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/09/2020 |
Last Update Date | 03/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
113288 | NEBRASKA STATE APRN LICENSE (01) | NE |
28330 | APRN LICENSE TENNESSEE (01) | TN |