Provider Demographics
NPI:1225261829
Name:MILLER, JENNIFER CATHERINE (NNP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:CATHERINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 E 7TH AVE
Mailing Address - Street 2:UNIT 826
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80203-3439
Mailing Address - Country:US
Mailing Address - Phone:602-380-5178
Mailing Address - Fax:
Practice Address - Street 1:2023 W WILSHIRE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85009-2805
Practice Address - Country:US
Practice Address - Phone:602-380-5178
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0000567-C-NP363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal