Individual
MRS. MARSHA PATRICE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1583 WEST 18TH STREET, JACKSONVILLE, FL 32209-4866
(904) 888-1493
(904) 354-0830
Mailing address
PO BOX 12305, JACKSONVILLE, FL 32209-0305
(904) 234-1982
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN1316831
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
685158496
—
FL
05
—
689294900
—
FL
Enumeration date
11/01/2011
Last updated
07/18/2023
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