Healthcare Provider Details

I. General information

NPI: 1346401965
Provider Name (Legal Business Name): ASHLEY NOELLE MILLER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2008
Last Update Date: 05/23/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

166 STONERIDGE DRIVE SOUTH CAROLINA ONCOLOGY ASSOCIATES, PA
COLUMBIA SC
29045
US

IV. Provider business mailing address

166 STONERIDGE DRIVE SOUTH CAROLINA ONCOLOGY ASSOCIATES, PA
COLUMBIA SC
29045
US

V. Phone/Fax

Practice location:
  • Phone: 803-461-3000
  • Fax: 803-461-4914
Mailing address:
  • Phone: 803-461-3000
  • Fax: 803-461-4914

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3563
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number3563
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: