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Individual

MR. CARROLL KEATLEY MILLER II

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
1201 BROAD ROCK BLVD, RICHMOND, VA 23224-4915
(804) 675-5000
Mailing address
1350 WESTWOOD AVE UNIT 208, RICHMOND, VA 23227-4631

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001227192
VA
163W00000X
Registered Nurse
9308821
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
0024169026
VA

Other

Enumeration date
01/19/2010
Last updated
08/12/2014
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