Individual
SANDRA GAYLE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FAM NURSE PRACTIONER
Contact information
Practice address
1100 CARSON AVE, SUITE 201, LA JUNTA, CO 81050-2751
(719) 383-5900
Mailing address
1100 CARSON AVE, SUITE 201, LA JUNTA, CO 81050-2751
(719) 383-5900
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
NP-5129
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
74637801
—
CO
Enumeration date
12/29/2007
Last updated
07/07/2011
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