Individual
AMANDA B MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5000 W CHAMBERS ST, 7TH FLOOR, MILWAUKEE, WI 53210-1650
(414) 874-4077
(414) 874-4006
Mailing address
5000 W CHAMBERS ST, 7TH FLOOR, MILWAUKEE, WI 53210-1650
(414) 874-4077
(414) 874-4006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2183
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
K400092265
MEDICARE ID
—
Enumeration date
08/06/2007
Last updated
07/31/2014
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