Provider Demographics
NPI:1417565664
Name:MILLER, ASHLEY L (FNP)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8001 YOUREE DR
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71115-2302
Mailing Address - Country:US
Mailing Address - Phone:318-212-3456
Mailing Address - Fax:318-212-3885
Practice Address - Street 1:8001 YOUREE DR STE 400
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71115-2340
Practice Address - Country:US
Practice Address - Phone:318-212-3456
Practice Address - Fax:318-212-3885
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA213738363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily