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Individual

DR. JESSICA T MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DNP, FNP-BC

Contact information

Practice address
2100 N MAIN ST STE 304, CROWN POINT, IN 46307-1877
(574) 546-1900
(574) 546-1999
Mailing address
PO BOX 10299, FORT WAYNE, IN 46851-0299
(574) 546-1900
(574) 546-1999

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
3016536
KY
363LF0000X
Family Nurse Practitioner
4704377817
MI
363LF0000X
Family Nurse Practitioner
Primary
71010828A
IN

Other

Enumeration date
01/24/2021
Last updated
08/18/2021
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