Individual
LAVITA LASHONNA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1223 MARKET AVE N, CANTON, OH 44714-2603
(234) 999-4900
Mailing address
1223 MARKET AVE N, CANTON, OH 44714-2603
(234) 999-4900
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0031280
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
377935
RN LICENSE
OH
Enumeration date
06/01/2022
Last updated
07/15/2023
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