Individual
LISA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1615 MAIN ST, SUSANVILLE, CA 96130-4558
(530) 257-0603
Mailing address
PO BOX 1949, SUSANVILLE, CA 96130-1949
(530) 249-6084
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
4708635
CA
Other
Enumeration date
04/12/2021
Last updated
04/12/2021
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