Healthcare Provider Details

I. General information

NPI: 1184646630
Provider Name (Legal Business Name): JAMIE T. MILLER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE T. LYNCH APRN

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 01/08/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 HOSPITAL DR
MADISONVILLE KY
42431-1658
US

IV. Provider business mailing address

200 CLINIC DR
MADISONVILLE KY
42431-1661
US

V. Phone/Fax

Practice location:
  • Phone: 270-326-3800
  • Fax: 270-326-3805
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3004327
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: