Individual
MRS. AMANDA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4500 13TH ST, GULFPORT, MS 39501-2515
(228) 697-3832
Mailing address
12413 CORRIES PL, GULFPORT, MS 39503-8154
(228) 697-3832
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R871802
MS
363LF0000X
Family Nurse Practitioner
Primary
R871802
MS
Other
Enumeration date
12/08/2014
Last updated
01/22/2015
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