Provider Demographics
NPI:1003815283
Name:MILLER, KRISTIN M (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8110 N BROTHER BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38133-2760
Mailing Address - Country:US
Mailing Address - Phone:901-255-5221
Mailing Address - Fax:901-373-4511
Practice Address - Street 1:6750 POPLAR AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38138-7438
Practice Address - Country:US
Practice Address - Phone:901-756-6522
Practice Address - Fax:901-435-0928
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26510207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3090398Medicare ID - Type UnspecifiedMEDICARE
TNG00878Medicare UPIN