Provider Demographics
NPI:1073124764
Name:MILLER, JANAE (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:JANAE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3151 EAST RIVER ROAD PO BOX 474
Mailing Address - Street 2:
Mailing Address - City:NEWKIRK
Mailing Address - State:OK
Mailing Address - Zip Code:74647-0474
Mailing Address - Country:US
Mailing Address - Phone:580-362-1039
Mailing Address - Fax:580-362-1467
Practice Address - Street 1:3151 E RIVER RD
Practice Address - Street 2:
Practice Address - City:NEWKIRK
Practice Address - State:OK
Practice Address - Zip Code:74647-7517
Practice Address - Country:US
Practice Address - Phone:580-362-1039
Practice Address - Fax:580-362-1467
Is Sole Proprietor?:No
Enumeration Date:2020-08-14
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0123092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily