Individual
JESSICA EMMA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
925 BISHOP WALSH RD, CUMBERLAND, MD 21502-1845
(240) 362-7025
(240) 362-7064
Mailing address
19305 UPPER CONSOL RD NW, FROSTBURG, MD 21532-2185
(717) 375-8931
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R196698
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417460619
TYPE 2 NPI GROUP
MD
01
—
1669037008
TYPE 2 NPI GROUP
MD
05
—
392004600
—
MD
Enumeration date
11/16/2020
Last updated
12/10/2020
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