Individual
DIANE E MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
803 POPLAR ST, MURRAY, KY 42071-2432
(270) 762-1100
Mailing address
4601 PARK RD STE 300, CHARLOTTE, NC 28209-2290
(704) 323-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-08543
NC
363AM0700X
Medical Physician Assistant
Primary
PA1015
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0397730029
NSC #
NC
05
—
7100048060
—
KY
Enumeration date
12/21/2006
Last updated
08/02/2023
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