| NPI | 1821388836 | 
|---|---|
| Former Name | KELLY JENA MILLER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN187026)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN187026)  | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN187026)  | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN187026)  | |
| Enumeration Date | 2011-04-11 | 
| Last Update Date | 2021-11-30 |