Individual
CRISTAL MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2400 GREATSTONE PT, LEXINGTON, KY 40504-3274
(859) 218-5999
(859) 257-0670
Mailing address
615 ELSINORE PL STE 200, CINCINNATI, OH 45202-1457
(513) 834-7063
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA922
KY
363AM0700X
Medical Physician Assistant
PA922
KY
363AS0400X
Surgical Physician Assistant
PA922
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100008020
—
KY
Enumeration date
06/12/2006
Last updated
11/17/2022
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