Healthcare Provider Details

I. General information

NPI: 1891931069
Provider Name (Legal Business Name): GARNETTE MILLER DNP FNP BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2008
Last Update Date: 02/28/2025
Certification Date: 02/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 CASINO STRIP RESORT BLVD
ROBINSONVILLE MS
38664
US

IV. Provider business mailing address

1150 CASINO STRIP RESORT BLVD
ROBINSONVILLE MS
38664
US

V. Phone/Fax

Practice location:
  • Phone: 662-357-7707
  • Fax: 662-357-7807
Mailing address:
  • Phone: 662-357-7707
  • Fax: 662-357-7807

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2012019851
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPN0000013748
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number810545
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: