Provider Demographics
NPI:1154640308
Name:MILLER, CRISTEN
Entity Type:Individual
Prefix:
First Name:CRISTEN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 SPANISH TRL
Mailing Address - Street 2:97
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32504-4903
Mailing Address - Country:US
Mailing Address - Phone:321-960-7698
Mailing Address - Fax:
Practice Address - Street 1:4470 SPANISH TRL
Practice Address - Street 2:97
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32504-4903
Practice Address - Country:US
Practice Address - Phone:321-960-7698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-27
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist