Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | RN081901 | AZ |
NPI | 1265519300 |
---|---|
Provider Name | Mrs. Merri A Miller |
First Address | Tucson, AZ 85712-1275 |
Second Address | Tucson, AZ 85712-1275 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/07/2007 |