Individual
THEODORE RALPH MILLER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNPC-AG
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
(919) 350-8000
Mailing address
7640 WINNERS EDGE ST, RALEIGH, NC 27617-1928
(919) 922-0405
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5019653
NC
363LA2100X
Acute Care Nurse Practitioner
Primary
5019653
NC
363LG0600X
Gerontology Nurse Practitioner
5019653
NC
Other
Enumeration date
02/19/2024
Last updated
11/08/2024
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