Individual
SALLY L. MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1600 UNIVERSITY DR E, COLLEGE STATION, TX 77840-2642
(409) 691-3300
Mailing address
PO BOX 847556, DALLAS, TX 75284-7556
(254) 724-2111
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
219556
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N9162
BLUE SHIELD
TX
Enumeration date
04/07/2006
Last updated
07/10/2007
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