Provider Demographics
NPI:1609139385
Name:MILLER, KRISTEN LEIGH (APRN)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LEIGH
Last Name:MILLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:L
Other - Last Name:MALNASI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:2501 N ORANGE AVE
Mailing Address - Street 2:SUITE 689
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4603
Mailing Address - Country:US
Mailing Address - Phone:407-303-2024
Mailing Address - Fax:407-303-2038
Practice Address - Street 1:2501 N ORANGE AVE
Practice Address - Street 2:SUITE 689
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4603
Practice Address - Country:US
Practice Address - Phone:407-303-2024
Practice Address - Fax:407-303-2038
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN9277410363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health