Individual
AMBER MISCHELLE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13 HILLCREST DR, PONCA CITY, OK 74604-4808
(580) 401-0386
Mailing address
PO BOX 251, SHIDLER, OK 74652-0251
(580) 401-0386
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L0063270
OK
Other
Enumeration date
03/08/2021
Last updated
03/08/2021
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