Individual
MRS. AMANDA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1301 PRIMACY PKWY, MEMPHIS, TN 38119-0213
(901) 866-8812
Mailing address
1407 UNION AVE STE 700, MEMPHIS, TN 38104-3641
(901) 866-8622
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
56362
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04601392
—
MS
05
—
Q031567
—
TN
Enumeration date
04/25/2014
Last updated
03/10/2022
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