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Individual

CASEY MILLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
400 HEALTH PARK BLVD STE 221, ST AUGUSTINE, FL 32086-5784
(904) 819-4497
Mailing address
40 SEVEN WONDERS TRL, PALM COAST, FL 32164-5419

Taxonomy

Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
ARNP9308693
FL
363LF0000X
Family Nurse Practitioner
Primary
9308693
FL

Other

Enumeration date
10/10/2017
Last updated
10/11/2017
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