Provider Demographics
NPI:1841405974
Name:MILLER, JULIE A (CNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W FLETCHER ST
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-2301
Mailing Address - Country:US
Mailing Address - Phone:989-354-0845
Mailing Address - Fax:989-354-2965
Practice Address - Street 1:393 LONG RAPIDS RD
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1317
Practice Address - Country:US
Practice Address - Phone:989-354-0504
Practice Address - Fax:989-356-6981
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704141994363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5008752000OtherBCBS