Individual
ELESA ANN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1004 GREYSTONE SQ, JACKSON, TN 38305-3580
(731) 664-1773
(731) 664-1751
Mailing address
1367 RUTHERFORD ST, UNION CITY, TN 38261-5873
(731) 286-1900
(731) 286-1939
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
APN14222
TN
363LP2300X
Primary Care Nurse Practitioner
14222
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1518161
—
TN
Enumeration date
01/08/2010
Last updated
11/05/2019
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