Provider Demographics
NPI:1003042078
Name:MILLER, LAUREN E (PA)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:E
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:1419 HAMRIC DR E
Mailing Address - Street 2:#101
Mailing Address - City:OXFORD
Mailing Address - State:AL
Mailing Address - Zip Code:36203-2173
Mailing Address - Country:US
Mailing Address - Phone:256-235-3660
Mailing Address - Fax:256-235-3663
Practice Address - Street 1:101 CHERRY ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5234
Practice Address - Country:US
Practice Address - Phone:256-543-2380
Practice Address - Fax:850-522-8354
Is Sole Proprietor?:No
Enumeration Date:2009-06-04
Last Update Date:2017-02-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ALPA642363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL187745Medicaid
AL187745Medicaid