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General NPI Number Information
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NPI Number | 1770846487
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Entity Type | Individual
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Provider Name | KATY ELIZABETH MILLER PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 03/26/2021
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Provider Practice Location Address
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Address Line | 3 GUTHRIE DR
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City | CORNING
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State | NY
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Zip | 14830-3696
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Country | US
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Telephone | 607-738-6560
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Fax | 570-887-2364
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Provider Business Mailing Address
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Address Line | 1 GUTHRIE SQ
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City | SAYRE
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State | PA
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Zip | 18840-1625
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Country | US
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Telephone | 570-888-5858
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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 |
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License Number State |
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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 | MA055560
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License Number State | PA
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