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General NPI Number Information
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NPI Number | 1417370479
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Entity Type | Individual
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Provider Name | SELEANA MILLER CRNA
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Gender | Female
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Dates
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Enumeration Date | 01/28/2014
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Last Update Date | 03/18/2014
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Provider Practice Location Address
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Address Line | 100 NORTHCREST DR
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City | SPRINGFIELD
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State | TN
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Zip | 37172-3927
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Country | US
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Telephone | 866-362-6963
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Fax | 866-362-4202
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Provider Business Mailing Address
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Address Line | 716 W BROOKHAVEN CIR
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City | MEMPHIS
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State | TN
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Zip | 38117-4504
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Country | US
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Telephone | 901-844-1590
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Fax | 901-844-1592
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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 | APN18370
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License Number State | TN
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