Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | RN185314 | GA |
Y | 363LA2200X | Nurse Practitioner - Adult Health | RN185314 | GA |
N | 363LG0600X | Nurse Practitioner - Gerontology | RN185314 | GA |
NPI | 1023380151 |
---|---|
Provider Name | Mrs. Tonia T Miller |
First Address | Hampton, GA 30228-4061 |
Second Address | Hampton, GA 30228-4061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2012 |
Last Update Date | 11/10/2018 |