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MR. KEVIN NATHANIEL MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPN

Contact information

Practice address
12203 ROUNDTABLE DRIVE, SEWARD, AK 99664-0334
(907) 980-5860
Mailing address
PO BOX 334, SEWARD, AK 99664-0334
(907) 362-6022

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
5293
AK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LP0006
AK
Enumeration date
09/18/2009
Last updated
01/25/2012
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