Individual
JACLYN KATE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1900 ELECTRIC RD, SALEM, VA 24153-7494
(540) 776-4000
Mailing address
30 BROOK DR, UNION HALL, VA 24176-2319
(330) 979-0340
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001250947
VA
367500000X
Certified Registered Nurse Anesthetist
Primary
0024179350
VA
Other
Enumeration date
03/10/2020
Last updated
09/22/2022
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