Individual
CHARLENE RENE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
200 HAWTHORNE LN, CHARLOTTE, NC 28204-2515
(704) 384-4021
(704) 384-5601
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-4021
(704) 384-5601
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5004724
NC
363LP0200X
Pediatric Nurse Practitioner
5004724
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5905265
—
NC
Enumeration date
04/30/2010
Last updated
06/08/2023
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