Individual
MS. KAYLA JOY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
11850 BLACKFOOT ST NW STE 130, COON RAPIDS, MN 55433-2583
(763) 236-9000
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
13759
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1185360
NCCPA
MN
Enumeration date
05/26/2021
Last updated
09/15/2021
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