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Individual

LEE ANN MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP-ACNP-BC

Contact information

Practice address
2121 LAKE AVENUE, FORT WAYNE, IN 46805-5100
(260) 426-5431
(260) 421-1834
Mailing address
1875 ROAD 203, CLOVERDALE, OH 45827
(260) 426-5431
(260) 421-1834

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
281647
OH
363LA2100X
Acute Care Nurse Practitioner
71007636
IN
363LA2100X
Acute Care Nurse Practitioner
COA.13299
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0065841
OH
Enumeration date
05/02/2012
Last updated
08/26/2022
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