Individual
SHANE RENEE BLACKWELL MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
933 GARRETT DR, BIRMINGHAM, AL 35235-1420
(205) 746-0325
Mailing address
516 E NIZHONI BLVD, GALLUP, NM 87301-5748
(505) 722-1000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN-80007
NM
Other
Enumeration date
08/12/2020
Last updated
06/01/2021
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