Provider Demographics
NPI:1790328235
Name:MILLER, ELIZABETH MAE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MAE
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4435 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37917-1300
Mailing Address - Country:US
Mailing Address - Phone:865-544-6222
Mailing Address - Fax:865-544-6223
Practice Address - Street 1:4435 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37917-1300
Practice Address - Country:US
Practice Address - Phone:865-544-6222
Practice Address - Fax:865-544-6223
Is Sole Proprietor?:No
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN26717363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily