Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | SP016368 | PA |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | SP016368 | PA |
NPI | 1003363839 |
---|---|
Provider Name | Stephanie E Miller |
First Address | Pittsburgh, PA 15222-3208 |
Second Address | Pittsburgh, PA 15222-3208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2016 |
Last Update Date | 12/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
103193502 | (05) | PA |
13898800 | CAQH (01) |