Individual
DEBRA LYNN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
611 E DOUGLAS RD STE 108, MISHAWAKA, IN 46545-1464
(574) 968-9100
(574) 243-1141
Mailing address
611 E DOUGLAS RD STE 108, MISHAWAKA, IN 46545-1464
(574) 968-9100
(574) 243-1141
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
28145260A
IN
367500000X
Certified Registered Nurse Anesthetist
28145260A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
28145260A
INDIANA MEDICAL LICENSE
IN
Enumeration date
04/02/2021
Last updated
05/14/2021
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