Healthcare Provider Details

I. General information

NPI: 1154440915
Provider Name (Legal Business Name): JAIME ELIZABETH MILLER CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST
ATLANTA GA
30365
US

IV. Provider business mailing address

550 PEACHTREE ST
ATLANTA GA
30365
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-3360
  • Fax:
Mailing address:
  • Phone: 404-727-3360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License NumberRN154270
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: