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Individual

KIM MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APN/CNP

Contact information

Practice address
1200 N STATE HIGHWAY 121, MT ZION, IL 62549-1224
(217) 864-5531
(217) 864-2449
Mailing address
1200 N STATE HIGHWAY 121, MT ZION, IL 62549-1224
(217) 864-5531
(217) 864-2449

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209004811
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036068658
IL
Enumeration date
06/08/2005
Last updated
03/10/2011
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