Individual
LOGAN MCKENZIE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1530 LONE OAK RD, PADUCAH, KY 42003-7901
(270) 444-2444
Mailing address
604 N 36TH ST, PADUCAH, KY 42001-4719
(270) 601-3685
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3016215
KY
363LF0000X
Family Nurse Practitioner
1127765
KY
Other
Enumeration date
06/22/2021
Last updated
08/19/2021
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