Healthcare Provider Details

I. General information

NPI: 1194037739
Provider Name (Legal Business Name): JACLYN MILLER PIASTA DNP, APRN, WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JACLYN ANN MILLER APRN

II. Dates (important events)

Enumeration Date: 07/12/2010
Last Update Date: 10/09/2025
Certification Date: 10/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

519 JOHNSON FERRY RD STE 300
MARIETTA GA
30068-4660
US

IV. Provider business mailing address

4523 HUNTING HOUND LN
MARIETTA GA
30062-6337
US

V. Phone/Fax

Practice location:
  • Phone: 404-490-1739
  • Fax: 877-649-6022
Mailing address:
  • Phone: 908-227-4773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP119517
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN316599
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberNP316599
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number004972
License Number StateAR
# 5
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: