Individual
LISA M MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1116 MILLIS AVE, STE 101, BOONVILLE, IN 47601-2292
(812) 897-7107
Mailing address
1116 MILLIS AVE STE 101, BOONVILLE, IN 47601-2226
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001974A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200303730
—
IN
05
—
78015146
—
KY
Enumeration date
09/23/2005
Last updated
10/10/2024
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