Individual
KAYLEE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CSFA
Contact information
Practice address
4517 W MCINTOSH RD, GRIFFIN, GA 30223-6129
(404) 862-0746
Mailing address
PO BOX 404, BROOKS, GA 30205-0404
(404) 862-0746
(470) 514-5561
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
246ZC0007X
NB0117582
GA
Enumeration date
12/19/2021
Last updated
02/01/2022
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