Individual
MARISSA ANNE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1010 N CENTER ST, LONOKE, AR 72086-2005
(501) 438-8075
(870) 856-2107
Mailing address
4196 HIGHWAY 62 412 STE A, HARDY, AR 72542-8002
(870) 856-1202
(870) 856-2107
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PT2021
AR
Other
Enumeration date
08/13/2021
Last updated
08/23/2021
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