Healthcare Provider Details

I. General information

NPI: 1619361201
Provider Name (Legal Business Name): JAMIE LEE MILLER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JAMIE LEE WERTS

II. Dates (important events)

Enumeration Date: 03/23/2015
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 ROCKSIDE WOODS BLVD N SUITE 425
INDEPENDENCE OH
44131-2366
US

IV. Provider business mailing address

719 PARKSIDE BLVD
CLEVELAND OH
44143-2815
US

V. Phone/Fax

Practice location:
  • Phone: 216-643-2780
  • Fax: 216-524-0111
Mailing address:
  • Phone: 440-596-8956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN.356796
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: