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General NPI Number Information
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NPI Number | 1912972175
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Entity Type | Individual
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Provider Name | KRISTOPHER JAMES MILLER MSPA
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Gender | Male
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 03/01/2011
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Provider Practice Location Address
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Address Line | 3225 HOSPITAL DR UNIT 101A
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City | JUNEAU
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State | AK
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Zip | 99801-7863
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Country | US
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Telephone | 907-523-5411
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Fax | 907-523-9884
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Provider Business Mailing Address
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Address Line | 3225 HOSPITAL DR UNIT 101A
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City | JUNEAU
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State | AK
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Zip | 99801-7863
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Country | US
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Telephone | 907-523-5411
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Fax | 907-523-9884
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA00769
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 944
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License Number State | AK
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