Individual
MALISSA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
107 N MAIN ST STE 2A, COLUMBIA, IL 62236-1757
(618) 693-9313
Mailing address
107 N MAIN ST STE 2A, COLUMBIA, IL 62236-1757
(618) 693-9313
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
277002437
IL
Other
Enumeration date
08/10/2018
Last updated
11/28/2023
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