Individual
NICOLE E MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 254-4887
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11192
MN
Other
Enumeration date
07/24/2012
Last updated
08/06/2019
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