Provider Demographics
NPI:1578288320
Name:MILLER, EMILY ANNE (MS, RN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANNE
Last Name:MILLER
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Gender:F
Credentials:MS, RN, PMHNP-BC
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Mailing Address - Street 1:4240 PARK GLEN RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5427
Mailing Address - Country:US
Mailing Address - Phone:612-925-6033
Mailing Address - Fax:612-925-8496
Practice Address - Street 1:149 THOMPSON AVE E STE 150
Practice Address - Street 2:
Practice Address - City:WEST ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55118-3238
Practice Address - Country:US
Practice Address - Phone:651-450-0860
Practice Address - Fax:651-450-0759
Is Sole Proprietor?:No
Enumeration Date:2022-10-04
Last Update Date:2022-10-10
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Provider Licenses
StateLicense IDTaxonomies
MN2391377163W00000X
MN9585363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse