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General NPI Number Information
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NPI Number | 1558785147
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Entity Type | Individual
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Provider Name | KRISTINA OLIVIA MILLER ATC, PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 11/06/2025
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Provider Practice Location Address
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Address Line | 1500 GALEN ST SE
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City | WASHINGTON
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State | DC
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Zip | 20020-4913
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Country | US
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Telephone | 202-469-4699
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Fax |
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Provider Business Mailing Address
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Address Line | 4526 CAVALIER CT
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City | WHITE PLAINS
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State | MD
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Zip | 20695-4403
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Country | US
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Telephone | 757-268-2920
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | A0000580
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA200002324
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License Number State | DC
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