Individual
BILLY B MILLER III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
2510 BERT KOUNS INDUSTRIAL LOOP, SHREVEPORT, LA 71118-3119
(318) 212-5000
Mailing address
2439 CHUCHILL DRIVE, BOSSIER CITY, LA 71111
(318) 741-0863
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN075386
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1176109
—
LA
Enumeration date
02/23/2006
Last updated
08/06/2008
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