Individual
SANDRA BETH MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
718 JUPITER DR, MADISON, WI 53718-2950
(872) 231-3162
Mailing address
PO BOX 74008272, CHICAGO, IL 60674-8272
(702) 899-0595
(702) 977-1496
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2987-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275888760
—
WI
Enumeration date
07/20/2012
Last updated
10/03/2025
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