Provider Demographics
NPI:1821712944
Name:MILLER, CHRISTINE KELLI (DNP)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:KELLI
Last Name:MILLER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:KELLI
Other - Last Name:OTTO, NEIGEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:123 CALLY LN
Mailing Address - Street 2:
Mailing Address - City:KALISPELL
Mailing Address - State:MT
Mailing Address - Zip Code:59901-2588
Mailing Address - Country:US
Mailing Address - Phone:406-471-8683
Mailing Address - Fax:
Practice Address - Street 1:160 HERITAGE WAY STE 202
Practice Address - Street 2:
Practice Address - City:KALISPELL
Practice Address - State:MT
Practice Address - Zip Code:59901-3127
Practice Address - Country:US
Practice Address - Phone:406-752-8433
Practice Address - Fax:406-756-6768
Is Sole Proprietor?:No
Enumeration Date:2022-10-03
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-198153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily