Individual
JAN LORRAINE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3103 E STATE BLVD, FORT WAYNE, IN 46805-4738
(260) 373-9300
Mailing address
3103 E STATE BLVD, FORT WAYNE, IN 46805-4738
(260) 373-9300
Taxonomy
Speciality
Code
Description
License number
State
363LX0106X
Occupational Health Nurse Practitioner
Primary
71004595A
IN
Other
Enumeration date
10/15/2013
Last updated
10/15/2013
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