Provider Demographics
NPI:1457008989
Name:MILLER, TANJELA SYLANE (FNP-C)
Entity Type:Individual
Prefix:
First Name:TANJELA
Middle Name:SYLANE
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:43 WATER ST APT 3
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03766-1673
Mailing Address - Country:US
Mailing Address - Phone:404-337-6280
Mailing Address - Fax:
Practice Address - Street 1:43 WATER ST APT 3
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03766-1673
Practice Address - Country:US
Practice Address - Phone:404-337-6280
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-04
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH087045-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily