Organization
CLINICAL SUPPORT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN M MILLER NP (NURSE PRACTITIONER)
(618) 558-3955
Entity
Organization
Contact information
Practice address
1501 LOCUST ST APT 906, SAINT LOUIS, MO 63103-1847
(618) 558-3955
Mailing address
1501 LOCUST ST APT 906, SAINT LOUIS, MO 63103-1847
(618) 558-3955
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209001766
IL
Other
Enumeration date
08/17/2009
Last updated
11/30/2009
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