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General NPI Number Information
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NPI Number | 1053977082
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Entity Type | Individual
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Provider Name | ELYSE CHRISTINE MILLER BSN
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Gender | Female
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Dates
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Enumeration Date | 05/15/2019
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Last Update Date | 05/15/2019
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Provider Practice Location Address
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Address Line | 8140 N MOPAC EXPY STE 3-210
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City | AUSTIN
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State | TX
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Zip | 78759-8859
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Country | US
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Telephone | 800-243-3839
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Fax |
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Provider Business Mailing Address
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Address Line | 10979 LOST LAKE DR APT 207
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City | NAPLES
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State | FL
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Zip | 34105-3168
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Country | US
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Telephone | 586-744-3656
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 9432524
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License Number State | FL
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