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General NPI Number Information
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NPI Number | 1639112212
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Entity Type | Individual
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Provider Name | LORI JANE MILLER RN, WHCNP
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Gender | Female
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 10/31/2019
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Provider Practice Location Address
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Address Line | 17 EXCHANGE ST W STE 622
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City | SAINT PAUL
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State | MN
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Zip | 55102-1225
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Country | US
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Telephone | 651-297-9141
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Fax |
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Provider Business Mailing Address
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Address Line | 1655 BEAM AVE STE 102
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City | MAPLEWOOD
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State | MN
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Zip | 55109-1475
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Country | US
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Telephone | 651-257-9622
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | R155474-6
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License Number State | MN
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