Individual
KELLY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CCRN
Contact information
Practice address
75 N COUNTRY RD, PORT JEFFERSON, NY 11777-2119
(631) 473-1320
Mailing address
1 BOBCAT LN, EAST SETAUKET, NY 11733-3602
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
735050
NY
Other
Enumeration date
04/14/2020
Last updated
04/14/2020
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