Individual
DIANE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1072 S DIXIE BLVD, RADCLIFF, KY 40160-1103
(270) 351-8166
(270) 351-8322
Mailing address
107 CRANES ROOST CT, ELIZABETHTOWN, KY 42701-3650
(270) 765-2605
(270) 766-1222
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
30515
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000174444
ANTHEM
KY
01
—
10805024
CAQH
—
01
—
227791
TRICARE
KY
05
—
30605018
—
KY
Enumeration date
05/25/2006
Last updated
07/09/2007
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