Individual
DIANA S MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(478) 697-2545
Mailing address
111 WILLOW DR, COCHRAN, GA 31014-8221
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN159335
GA
363LF0000X
Family Nurse Practitioner
Primary
RN159335
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RN159335
RN GEORGIA LICENSE
GA
Enumeration date
05/08/2014
Last updated
09/16/2020
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