Individual
LESLIE LYNN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
325 N LAFAYETTE BLVD, SOUTH BEND, IN 46601-1208
(574) 647-2100
Mailing address
3355 DOUGLAS RD, SUITE 300, SOUTH BEND, IN 46635-1781
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
28141521A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200424820
—
IN
Enumeration date
06/09/2008
Last updated
06/09/2008
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