Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 26NJ00099700 | NJ |
NPI | 1003853854 |
---|---|
Provider Name | Mrs. Juliana Miller |
First Address | Medford, NJ 08055-2431 |
Second Address | Medford, NJ 08055-2371 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2006 |
Last Update Date | 22/11/2021 |