Healthcare Provider Details

I. General information

NPI: 1003731241
Provider Name (Legal Business Name): KERITH ALLENE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 GREGG HWY NW
AIKEN SC
29801-6341
US

IV. Provider business mailing address

825 AUDUBON CIR
NORTH AUGUSTA SC
29841-2740
US

V. Phone/Fax

Practice location:
  • Phone: 803-641-7700
  • Fax:
Mailing address:
  • Phone: 803-640-1709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: