Provider Demographics
NPI:1437424306
Name:MILLER, KELLIE (ACNP)
Entity Type:Individual
Prefix:
First Name:KELLIE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-4925
Mailing Address - Fax:614-293-5503
Practice Address - Street 1:2050 KENNY RD STE 2200
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43221-3502
Practice Address - Country:US
Practice Address - Phone:614-293-4925
Practice Address - Fax:142-935-5036
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2022-03-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TX700266363LA2100X
OHAPRN.CNP.16823363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care