Provider Demographics
NPI:1275533572
Name:MILLER, CYNTHIA A (ANP-C)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:ANP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:135 VALLEYOAK CT
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-7428
Mailing Address - Country:US
Mailing Address - Phone:336-766-2091
Mailing Address - Fax:336-766-2091
Practice Address - Street 1:104 W MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-6773
Practice Address - Country:US
Practice Address - Phone:336-224-0931
Practice Address - Fax:336-224-0932
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC900426363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC150153OtherNC BOARD OF NURSING
NC10740OtherBOARD OF PHARMACY LICENSE
NC900426OtherSTATE LICENSE
NCA0404040OtherAANP
NCMM1086277OtherDEA
NC10740OtherBOARD OF PHARMACY LICENSE