Healthcare Provider Details

I. General information

NPI: 1184980153
Provider Name (Legal Business Name): JESSICA LEE MILLER M.D., MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2012
Last Update Date: 07/21/2022
Certification Date: 03/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

648 HARTSVILLE PIKE
GALLATIN TN
37066-2523
US

IV. Provider business mailing address

3841 GREEN HILLS VILLAGE DR STE 200
NASHVILLE TN
37215-2691
US

V. Phone/Fax

Practice location:
  • Phone: 615-451-9246
  • Fax:
Mailing address:
  • Phone: 615-936-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number074230
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: