Individual
CARISSA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
911 STOWELL ST, ELMIRA, NY 14901-1428
(607) 737-5215
Mailing address
4612 MILLENNIUM DR, GENESEO, NY 14454-1197
(585) 443-2018
(585) 991-5013
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
798087-01
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16-1039939
ALL OTHER INSURNACES
NY
05
—
16-1069939
—
NY
Enumeration date
01/09/2023
Last updated
11/11/2025
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