# LISA M MILLER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194547836
- **Authorized official:** LISA M MILLER APRN (OWNER)
- **Authorized official phone:** (208) 741-6159

## Contact information

- **Practice address:** 1950 E CLARK ST STE 10, POCATELLO, ID 83201-3314
- **Practice address phone:** (208) 741-6159
- **Mailing address:** 941 CASTLE ST, CHUBBUCK, ID 83202-3010
- **Mailing address phone:** (208) 741-6159

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 10/24/2024
- **Last updated:** 10/24/2024