Individual
AMANDA MILLER
Active
Individual
AMANDA MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201185770
—
IN
05
—
300005162
—
IN
01
—
P01307690
MEDICARE RR PTAN
IN
Enumeration date
07/23/2013
Last updated
11/27/2023
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