Individual
DR. JACKY ADAM MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP,FAWM
Contact information
Practice address
2095 N DOLORES RD, CORTEZ, CO 81321-8924
(970) 564-8086
(970) 564-8087
Mailing address
2095 N DOLORES RD, CORTEZ, CO 81321-8924
(970) 564-8086
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
167292
CO
363LA2100X
Acute Care Nurse Practitioner
Primary
5008214
NC
363LA2100X
Acute Care Nurse Practitioner
624662
TX
363LA2100X
Acute Care Nurse Practitioner
R51146
NM
Other
Enumeration date
07/18/2006
Last updated
04/09/2019
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