Healthcare Provider Details

I. General information

NPI: 1396502332
Provider Name (Legal Business Name): CHRISTINE MILLER WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/05/2024
Last Update Date: 01/06/2026
Certification Date: 01/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 MAIN ST STE 102
BIDDEFORD ME
04005-2432
US

IV. Provider business mailing address

33 HILLSIDE RD
MANCHESTER ME
04351-3703
US

V. Phone/Fax

Practice location:
  • Phone: 207-282-6200
  • Fax:
Mailing address:
  • Phone: 207-441-4194
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SW0102X
TaxonomyWomen's Health Clinical Nurse Specialist
License NumberCNP231624
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: