Individual
MRS. LISA ALLINE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2097 HENRY TECKLENBURG DR STE 201W, CHARLESTON, SC 29414-5739
(843) 402-1211
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
22709
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP6343
—
SC
Enumeration date
06/25/2019
Last updated
11/18/2021
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