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General NPI Number Information
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NPI Number | 1679163141
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Entity Type | Individual
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Provider Name | JORDAN ELIZABETH MILLER
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Gender | Female
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Dates
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Enumeration Date | 01/19/2021
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Last Update Date | 04/29/2021
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Provider Practice Location Address
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Address Line | 97 CLINTON AVE
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City | ASHEVILLE
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State | NC
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Zip | 28806-2455
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Country | US
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Telephone | 479-856-3052
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Fax |
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Provider Business Mailing Address
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Address Line | 97 CLINTON AVE
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City | ASHEVILLE
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State | NC
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Zip | 28806-2455
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Country | US
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Telephone | 479-856-3052
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1175830
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License Number State | NC
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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 | 0010-10961
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License Number State | NC
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