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Individual

MS. LADONNA ANN MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CST/CSFA, KCSA

Contact information

Practice address
2601 KENTUCKY AVE, DOCTOR'S BUILDING 1, SUITE 103, PADUCAH, KY 42003-3817
(270) 444-9199
Mailing address
2707 MADISON ST, PADUCAH, KY 42001-3733
(270) 217-3276

Taxonomy

Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
106545
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SA227
KENTUCKY BOARD OF MEDICAL LICENSURE
KY
Enumeration date
07/01/2009
Last updated
04/09/2012
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