Individual
KARISSA R MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
945 N 12TH ST, MILWAUKEE, WI 53233-1305
(715) 346-5000
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(414) 219-2000
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
61425
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100039147
—
WI
01
—
61425-20
WI STATE LIC
WI
Enumeration date
04/01/2011
Last updated
10/27/2023
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