Individual
BRENT JOHN MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
212 S SULLIVAN, FREMONT, MI 49412
(231) 924-1300
Mailing address
2537 MOMENTUM PL, CHICAGO, IL 60689-0001
(616) 975-1845
(616) 975-1870
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704186025
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500027220
RAILROAD MEDICARE
MI
Enumeration date
08/13/2006
Last updated
08/03/2009
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