Individual
JARED DREW MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2300 E 30TH ST BLDG D, STE 101, FARMINGTON, NM 87401-8990
(505) 327-1400
(505) 564-3202
Mailing address
2300 E 30TH ST BLDG D, STE 101, FARMINGTON, NM 87401-8990
(505) 327-1400
(505) 564-3202
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2013-0009
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA2013-0009
STATE LIC.
NM
Enumeration date
03/01/2013
Last updated
03/01/2013
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