Individual
MRS. VANESSA L MIILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
708 8TH ST, ARMOUR, SD 57313-2102
(605) 724-2151
(605) 724-2310
Mailing address
PO BOX 295, CORSICA, SD 57328-0295
(605) 946-5775
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0214
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21229
SIOUX VALLEY HEALTH PLAN
SD
01
—
4999898
BLUE CROSS
SD
05
—
6820243
—
SD
Enumeration date
06/14/2005
Last updated
12/06/2011
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