Individual
LINDA E MILLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
RN MSN CS APN
Contact information
Practice address
810 DERHAKE RD, FLORISSANT, MO 63033-5823
(314) 388-5201
(636) 230-0421
Mailing address
810 DERHAKE RD, FLORISSANT, MO 63033-5823
(314) 388-5201
(636) 230-0421
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
RN554563
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
157244
BLUE CROSS BLUE SHIELD
MO
01
—
89000095
FEDERAL MEDICARE
—
Enumeration date
10/06/2005
Last updated
07/08/2007
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