Provider Demographics
NPI:1639575988
Name:MILLER, JONATHAN DOW (FNP-C)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:DOW
Last Name:MILLER
Suffix:
Gender:M
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 1:2021 CHURCH ST
Mailing Address - Street 2:STE. 305
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2021
Mailing Address - Country:US
Mailing Address - Phone:615-329-5072
Mailing Address - Fax:615-329-5834
Practice Address - Street 1:2021 CHURCH ST
Practice Address - Street 2:STE. 305
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2021
Practice Address - Country:US
Practice Address - Phone:615-329-5072
Practice Address - Fax:615-329-5834
Is Sole Proprietor?:No
Enumeration Date:2014-11-14
Last Update Date:2016-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19210363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ011382Medicaid
TNQ011382Medicaid