MEDICARE: MS. KATHLEEN ROSINA MILLER R.N.

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
1	163WC1500X	Community Health Registered Nurse	RN0000108140	TN

General Provider Information

NPI Number	:	1568668721
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATHLEEN ROSINA MILLER R.N.

Provider Business Mailing Address
First Line	:	2847 OLD HICKORY BLVD
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-3718
Country	:	US
Telephone Number	:	615-862-7942
Fax Number	:	615-880-1986

Provider Business Practice Location Address
First Line	:	3718 NOLENSVILLE PIKE
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-3302
Country	:	US
Telephone Number	:	615-862-7942
Fax Number	:	615-880-1986

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/25/2007
Last Update Date	:	07/08/2007

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