Individual
BRENDA K MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN RNC NP
Contact information
Practice address
705 NE JEFFERSON AVE, PEORIA, IL 61603-3843
(309) 673-0907
(309) 673-6914
Mailing address
1116 N SUMMIT BLVD, PEORIA, IL 61606-1080
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
209-001737
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041289753
RN LICENSE
IL
01
—
209001737
APN LICENSE
IL
Enumeration date
02/03/2006
Last updated
07/08/2007
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