Provider Demographics
NPI:1700420346
Name:MILLER, ERIN LORETTA (APRN, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:LORETTA
Last Name:MILLER
Suffix:
Gender:F
Credentials:APRN, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3830 EVANS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33901-9305
Mailing Address - Country:US
Mailing Address - Phone:239-939-2808
Mailing Address - Fax:239-939-4794
Practice Address - Street 1:3830 EVANS AVE
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33901-9305
Practice Address - Country:US
Practice Address - Phone:239-939-2808
Practice Address - Fax:239-939-4794
Is Sole Proprietor?:No
Enumeration Date:2019-11-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26544163WP0200X
FL11004860163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics