Individual
COURTNEY A MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
1800 CAMELOT DR, SUITE 300, VIRGINIA BEACH, VA 23454-2440
(757) 321-3383
(757) 321-3332
Mailing address
230 CLEARFIELD AVE, SUITE 124, VIRGINIA BEACH, VA 23462-1832
(757) 321-3383
(757) 321-3332
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003743
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912297821
—
VA
01
—
541869550
TRICARE
VA
Enumeration date
04/12/2011
Last updated
09/25/2015
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