Individual
JOANNA L MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5371
(740) 446-5711
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5371
(740) 446-5711
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12558-NP
OH
363LP0200X
Pediatric Nurse Practitioner
APRN.CNP.12558
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000471781
OHIO MEDICAID UNISON
OH
01
—
0054878
OH MEDICAID MOLINA
OH
05
—
0054878
—
OH
01
—
310917085268
OH MEDICAID CARESOURCE
OH
05
—
3810021497
—
WV
Enumeration date
09/01/2011
Last updated
11/05/2020
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