Provider Demographics
NPI:1154663334
Name:MILLER, LAUREN LINN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:LINN
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:MANTI
Mailing Address - State:UT
Mailing Address - Zip Code:84642
Mailing Address - Country:US
Mailing Address - Phone:435-835-6000
Mailing Address - Fax:435-835-6004
Practice Address - Street 1:45 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:MANTI
Practice Address - State:UT
Practice Address - Zip Code:84642
Practice Address - Country:US
Practice Address - Phone:435-835-6000
Practice Address - Fax:435-835-6004
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT215898-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily