Healthcare Provider Details

I. General information

NPI: 1831794981
Provider Name (Legal Business Name): KRISTI ANN MILLER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/04/2020
Last Update Date: 04/04/2023
Certification Date: 04/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 PEPPERELL PKWY
OPELIKA AL
36801-5422
US

IV. Provider business mailing address

1322 N DEAN RD APT 905
AUBURN AL
36830-7642
US

V. Phone/Fax

Practice location:
  • Phone: 334-528-2001
  • Fax:
Mailing address:
  • Phone: 334-559-1835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-151211
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207QA0000X
TaxonomyAdolescent Medicine (Family Medicine) Physician
License Number1-151211
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: