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Individual

KRISTINE E MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHNP

Contact information

Practice address
761 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 513-4000
(770) 995-3495
Mailing address
761 OLD NORCROSS RD, LAWRENCEVILLE, GA 30046-4317
(770) 513-4000
(770) 995-3495

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
RN064231
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000535312A
PEACH STATE
GA
01
00535312A
WELLCARE
GA
05
00535312A
GA
Enumeration date
01/23/2007
Last updated
01/31/2012
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