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Individual

MRS. JENNIFER MAE MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
14921 STONEGREEN LN, HUNTERSVILLE, NC 28078-9784
(717) 203-9503
Mailing address
14921 STONEGREEN LN, HUNTERSVILLE, NC 28078-9784
(717) 203-9503

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0010-03642
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1578768578
NC
01
178X3
BC/BS
NC
Enumeration date
06/19/2007
Last updated
07/09/2020
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