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NPI Code Detail

MEDICARE: KRISTIE S MILLER RN

MEDICARE: KRISTIE S MILLER RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered Nurse273124-3102UT

General Provider Information

NPI Number : 1366113417
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTIE S MILLER RN
Provider Business Mailing Address
First Line : 2838 W 9760 S
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-3250
Country : US
Telephone Number : 801-671-2462
Fax Number : 801-447-2521
Provider Business Practice Location Address
First Line : 2838 W 9760 S
Second Line :
City : SOUTH JORDAN
State : UT
Zip : 84095-3250
Country : US
Telephone Number : 801-671-2462
Fax Number : 801-446-2521
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2021
Last Update Date : 09/27/2021

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