Healthcare Provider Details

I. General information

NPI: 1942058573
Provider Name (Legal Business Name): SARAH MILLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2024
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 WILLMAR AVE SW
WILLMAR MN
56201-3556
US

IV. Provider business mailing address

245 E STATE HIGHWAY 55 APT 217
PAYNESVILLE MN
56362-2030
US

V. Phone/Fax

Practice location:
  • Phone: 320-231-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number15573
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: