Provider Demographics
NPI:1790063527
Name:MILLER, JANE G (MSN, NP)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:G
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:55 FRUIT ST
Mailing Address - Street 2:YAWKEY 9A
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-2621
Mailing Address - Country:US
Mailing Address - Phone:617-726-6500
Mailing Address - Fax:617-724-1079
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:YAWKEY 9A
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-6500
Practice Address - Fax:617-724-1079
Is Sole Proprietor?:No
Enumeration Date:2011-07-27
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN9400397363LA2200X
MA196727363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health