Individual
MS. MARTHA J MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BC-ACNP
Contact information
Practice address
724 LAKE DR, SANTA ROSA, NM 88435-2559
(575) 472-4311
(575) 472-4313
Mailing address
724 LAKE DR, SANTA ROSA, NM 88435-2559
(575) 472-4311
(575) 472-4313
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-01641
NM
Other
Enumeration date
05/11/2010
Last updated
04/22/2015
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