Individual
EBENEY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 E STATE BLVD, FORT WAYNE, IN 46805-4728
(574) 551-8030
Mailing address
4440 HILLEGAS RD, FORT WAYNE, IN 46818-1918
(574) 551-8030
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
287551A
IN
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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