Individual
ABIGAIL ROSE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
111 N 81ST ST, BELLEVILLE, IL 62223-2445
(804) 543-5105
Mailing address
111 N 81ST ST, BELLEVILLE, IL 62223-2445
(804) 543-5105
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
2020030713
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2023033314
MO
Other
Enumeration date
12/07/2022
Last updated
08/18/2023
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