| NPI | 1326640830 |
|---|---|
| Former Name | CHARLENE MICHELE MILLER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3014708) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3014708) |
| Enumeration Date | 2020-11-10 |
| Last Update Date | 2022-06-29 |