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Individual

LISA LYNETTE MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP, BSN, MN

Contact information

Practice address
4100 CAMPUS RIDGE DR, MIDLAND, MI 48640-6139
(989) 839-3393
Mailing address
4000 WELLNESS DR, MIDLAND, MI 48670-2000

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30007900
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
4704212348
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0248141
LABOR & INDUSTRIES
WA
01
2005009787-21
WA LIC
WA
01
200650026NP ACNP-PP
OR LICENSE
OR
05
9654609
WA
Enumeration date
12/19/2006
Last updated
11/07/2025
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