Provider Demographics
NPI:1841430816
Name:JOHNS-MILLER, KERI NICOLE (PHD)
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:NICOLE
Last Name:JOHNS-MILLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:KERI
Other - Middle Name:NICOLE
Other - Last Name:JOHNS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:600 S CHERRY ST STE 825
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-1795
Mailing Address - Country:US
Mailing Address - Phone:303-941-1769
Mailing Address - Fax:
Practice Address - Street 1:600 S CHERRY ST STE 825
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1795
Practice Address - Country:US
Practice Address - Phone:901-212-4907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-03
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004877103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COPSY.0004877OtherSTATE OF COLORADO LICENSE