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Individual
MARIANNE I MILLER
Active
Individual
MARIANNE I MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
20172
CA
363LP0200X
Pediatric Nurse Practitioner
Primary
209009289
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20172
NP LICENSE NUMBER
CA
01
—
209.009289
ILLINOIS NP LICENSE NUMBER
IL
Enumeration date
02/16/2011
Last updated
03/22/2012
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