Healthcare Provider Details

I. General information

NPI: 1942592035
Provider Name (Legal Business Name): LYNN MARIE MILLER NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2011
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MAIN ST
FOLLANSBEE WV
26037-1202
US

IV. Provider business mailing address

75 SAN CARLOS ST
WEIRTON WV
26062-5551
US

V. Phone/Fax

Practice location:
  • Phone: 304-505-6045
  • Fax: 844-689-4094
Mailing address:
  • Phone: 412-944-9033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.13229
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number64897
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: