Individual
JENNA RAE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
176 SUSAN DR, WESTFIELD, MA 01085-1435
(413) 454-2213
Mailing address
176 SUSAN DR, WESTFIELD, MA 01085-1435
(413) 454-2213
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA7281
MA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/22/2019
Last updated
07/15/2020
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