Provider Demographics
NPI:1467928614
Name:MILLER, LINDSAY NICOLE (PA)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:NICOLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5315 CHANTILLY LN
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29418-5704
Mailing Address - Country:US
Mailing Address - Phone:912-463-1520
Mailing Address - Fax:
Practice Address - Street 1:990 LAKE HUNTER CIR STE 1A
Practice Address - Street 2:
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-5426
Practice Address - Country:US
Practice Address - Phone:843-881-4117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-15
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant