Healthcare Provider Details

I. General information

NPI: 1487519815
Provider Name (Legal Business Name): RAINA MILLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

619 S 8TH ST
GRIFFIN GA
30224-4260
US

IV. Provider business mailing address

7621 SQUIRE CT
FAIRBURN GA
30213-1133
US

V. Phone/Fax

Practice location:
  • Phone: 470-267-1970
  • Fax:
Mailing address:
  • Phone: 850-899-0549
  • Fax: 850-899-0549

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP291007
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: