Individual
TIMOTHY MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
17431 N 71ST DR, STE 103, GLENDALE, AZ 85308-8598
(480) 521-6586
(623) 242-7856
Mailing address
17431 N 71ST DR, STE 103, GLENDALE, AZ 85308-8598
(480) 521-6586
(623) 242-7856
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP3087
AZ
363LP2300X
Primary Care Nurse Practitioner
AP2246
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
96322
AHCCCS NUMBER
AZ
Enumeration date
01/17/2006
Last updated
07/13/2016
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