Individual
CLAY ANTHONY MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
255 BERT KOUNS LOOP, SHREVEPORT, LA 71106-8150
(318) 683-0411
(318) 683-0743
Mailing address
1 SAINT MARY PLACE, PFS-PROF BILLING, SHREVEPORT, LA 71101
(318) 681-6878
(318) 681-6753
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN044445
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1960357
—
LA
Enumeration date
10/06/2006
Last updated
01/07/2022
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