Individual
JANIS DEANN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
302 NORTH MILL STREET, GREENUP, IL 62428
(217) 923-3311
(217) 923-5160
Mailing address
302 NORTH MILL STREET, GREENUP, IL 62428
(217) 923-3311
(217) 923-5160
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2009006355
IL
363LF0000X
Family Nurse Practitioner
71002505A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200876860
—
IN
01
—
209006355
LICENSE
IL
01
—
P00435500
RR MEDICARE
IN
Enumeration date
12/11/2006
Last updated
05/17/2021
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