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Individual

BRENNA LAINE MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
30900 SW PARKWAY AVE, WILSONVILLE, OR 97070-7835
(619) 992-2543
Mailing address
4560 SE INTERNATIONAL WAY STE 100, MILWAUKIE, OR 97222-4628
(619) 992-2543

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
202008544NP-PP
OR

Other

Enumeration date
12/20/2020
Last updated
12/20/2020
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