Individual
JESSICA R. MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
205 VALLEY AVE, WEST BEND, WI 53095-5312
(262) 338-1123
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(800) 326-2250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
71578
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1265969711
—
WI
Enumeration date
05/16/2017
Last updated
08/11/2025
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