Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 041359485 | IL |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 62189 | NM |
NPI | 1003184524 |
---|---|
Provider Name | Patricia J Miller |
First Address | Albuquerque, NM 87111-1622 |
Second Address | Albuquerque, NM 87108 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2011 |
Last Update Date | 28/05/2021 |