Individual
KENDAL W MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-9588
Mailing address
1090 ARNOLD DR, LITTLE ROCK AFB, AR 72099-4933
(501) 987-7445
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP06178
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1053625426
BCBS OF LA
LA
05
—
2125630
—
LA
Enumeration date
07/28/2010
Last updated
01/09/2024
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