Individual
WANDA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1 FREEDOM WAY, AUGUSTA, GA 30904-6258
(706) 733-0188
Mailing address
47 CHASTE TREE LN, MARTINEZ, GA 30907-3547
(706) 733-0188
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
R619183
MS
Other
Enumeration date
09/07/2006
Last updated
07/08/2007
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