Provider Demographics
NPI:1689882755
Name:MILLER, KIMBERLEY ANNE (RN, GNNP)
Entity Type:Individual
Prefix:
First Name:KIMBERLEY
Middle Name:ANNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, GNNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11134 ROUND MOUNTAIN DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-9017
Mailing Address - Country:US
Mailing Address - Phone:972-712-3524
Mailing Address - Fax:
Practice Address - Street 1:1301 CONCORD TER
Practice Address - Street 2:PEDIATRIX MEDICAL GROUP
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2843
Practice Address - Country:US
Practice Address - Phone:954-384-0175
Practice Address - Fax:877-780-4242
Is Sole Proprietor?:No
Enumeration Date:2007-05-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX638622163WN0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care