Individual
KELLY MARIE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1420 S BUSINESS 61 STE DEF, BOWLING GREEN, MO 63334-5230
(573) 324-5562
Mailing address
2305 GEORGIA ST, LOUISIANA, MO 63353-2559
(573) 754-4584
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2019010659
MO
Other
Enumeration date
04/03/2019
Last updated
05/24/2021
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