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Individual

JENNIFER MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, BSN, CDE

Contact information

Practice address
1200 E 3900 S, SALT LAKE CITY, UT 84124-1300
(801) 268-7930
Mailing address
PO BOX 271220, SALT LAKE CITY, UT 84127-1220
(801) 534-1360
(801) 366-9883

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
264712-3102
UT
163WD0400X
Diabetes Educator Registered Nurse
264712-3102
UT

Other

Enumeration date
10/20/2016
Last updated
10/20/2016
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