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NPI Code Detail

MEDICARE: MS. LAURA SOUTHERN MILLER APRN

MEDICARE: MS. LAURA SOUTHERN MILLER APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner5009155NC
2363LP2300XPrimary Care Nurse PractitionerRN182120GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1RN182120OTHERGAGEORGIA LICENSE #

General Provider Information

NPI Number : 1215377908
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAURA SOUTHERN MILLER APRN
Provider Business Mailing Address
First Line : PO BOX 1039
Second Line :
City : SYLVA
State : NC
Zip : 28779-1039
Country : US
Telephone Number : 828-631-3181
Fax Number : 828-631-6113
Provider Business Practice Location Address
First Line : 90 E MAIN ST STE 2
Second Line :
City : SYLVA
State : NC
Zip : 28779-3030
Country : US
Telephone Number : 828-631-3181
Fax Number : 828-631-6113
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2013
Last Update Date : 01/16/2020

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