MEDICARE: MRS. CASHMERE M MILLER NURSE PRACTITIONER

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	363LP2300X	Primary Care Nurse Practitioner	RN254513	GA

General Provider Information

NPI Number	:	1730787490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CASHMERE M MILLER NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	4091 BRIARGLADE WAY
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30340-5111
Country	:	US
Telephone Number	:	404-429-6581
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 CLAIRMONT RD
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-4032
Country	:	US
Telephone Number	:	404-321-6111
Fax Number	:

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

Provider Enumeration Date	:	10/14/2020
Last Update Date	:	10/14/2020

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