Healthcare Provider Details

I. General information

NPI: 1326972902
Provider Name (Legal Business Name): KRISTAN MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HARRISON PLZ
FLORENCE AL
35632-0002
US

IV. Provider business mailing address

117 ZHENDER CV
TUSCUMBIA AL
35674-6178
US

V. Phone/Fax

Practice location:
  • Phone: 256-765-4984
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-202044
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: