NPI | 1417953860 |
---|---|
Former Name | ELLEN MILLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP9439216) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 152847) |
Enumeration Date | 2005-06-21 |
Last Update Date | 2018-07-16 |