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NPI Code Detail

MEDICARE: MRS. GLORIA CAROL MILLER F.N.P..

MEDICARE: MRS. GLORIA CAROL MILLER F.N.P..
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
1363LF0000XFamily Nurse PractitionerAPN0000019520TN
2363LF0000XFamily Nurse Practitioner731716TX
3363LF0000XFamily Nurse PractitionerRN221558GA

General Provider Information

NPI Number : 1669763504
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GLORIA CAROL MILLER F.N.P..
Provider Business Mailing Address
First Line : 2994 ATLANTA RD SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-3655
Country : US
Telephone Number : 770-425-2178
Fax Number : 770-309-5762
Provider Business Practice Location Address
First Line : 2994 ATLANTA RD SE
Second Line :
City : SMYRNA
State : GA
Zip : 30080-3655
Country : US
Telephone Number : 770-435-2178
Fax Number : 770-507-9360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2011
Last Update Date : 07/09/2018

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