Individual
KIMBERLY DAWN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4829 N STATE ROAD 1, HAGERSTOWN FAMILY PRACTICE, HAGERSTOWN, IN 47346-9620
(765) 489-3935
(765) 489-6344
Mailing address
1100 REID PKWY, MEDICAL STAFF SERVICES, RICHMOND, IN 47374-1157
(765) 489-3935
(765) 489-6344
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71005072A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001012297
ANTHEM
IN
05
—
201251010
—
IN
Enumeration date
11/06/2006
Last updated
05/17/2021
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