Individual
ALEXANDRA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-1615
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
187661
AK
207P00000X
Emergency Medicine Physician
Primary
M-17356
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
MI
Other
Enumeration date
06/04/2018
Last updated
08/14/2023
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