Healthcare Provider Details

I. General information

NPI: 1992843148
Provider Name (Legal Business Name): DENISE A MILLER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2007
Last Update Date: 05/01/2023
Certification Date: 05/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2309 E 15TH ST
PANAMA CITY FL
32405-6345
US

IV. Provider business mailing address

403 E 11TH ST
PANAMA CITY FL
32401-3409
US

V. Phone/Fax

Practice location:
  • Phone: 850-747-5272
  • Fax:
Mailing address:
  • Phone: 850-767-3350
  • Fax: 850-767-3353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP 9250386
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: