Individual
CARISSA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
707 ROLLINGWOOD LN, FORT WAYNE, IN 46845-1088
(260) 255-8752
Mailing address
707 ROLLINGWOOD LN, FORT WAYNE, IN 46845-1088
(260) 255-8752
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71010075A
IN
Other
Enumeration date
06/05/2020
Last updated
08/21/2020
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