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Individual
MS. SHANNON MARIE MILLER
Active
Individual
MS. SHANNON MARIE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
P-T0620
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P-T0620
LICENSE -
AR
Enumeration date
10/31/2006
Last updated
07/08/2007
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