Provider Demographics
NPI:1326213927
Name:MILLER, ANTOINETTE LYNN (NP)
Entity Type:Individual
Prefix:MR
First Name:ANTOINETTE
Middle Name:LYNN
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1300 SAINT MARYS ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27605-1276
Mailing Address - Country:US
Mailing Address - Phone:919-828-0890
Mailing Address - Fax:919-828-0664
Practice Address - Street 1:1300 SAINT MARYS ST
Practice Address - Street 2:SUITE 400
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27605-1276
Practice Address - Country:US
Practice Address - Phone:919-828-0890
Practice Address - Fax:919-828-0664
Is Sole Proprietor?:No
Enumeration Date:2008-04-24
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC109595363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner