Individual
JESSICA ANN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
35 MICHIGAN ST NE, SUITE 4150, GRAND RAPIDS, MI 49503-2514
(616) 267-2600
(616) 267-2601
Mailing address
100 MICHIGAN ST NE, MC 845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601006024
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601006024
PA TASK FORCE
MI
Enumeration date
12/19/2011
Last updated
02/18/2021
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