Provider Demographics
NPI:1851537286
Name:MILLER, EMILY C (ANP BC)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:C
Last Name:MILLER
Suffix:
Gender:F
Credentials:ANP BC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:C
Other - Last Name:STOKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:702 SHERRILL ST STE B
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:TN
Mailing Address - Zip Code:38261-5891
Mailing Address - Country:US
Mailing Address - Phone:731-885-8884
Mailing Address - Fax:731-599-9713
Practice Address - Street 1:1720 E. REELFOOT AVE.
Practice Address - Street 2:STE 103
Practice Address - City:UNION CITY
Practice Address - State:TN
Practice Address - Zip Code:38261-6048
Practice Address - Country:US
Practice Address - Phone:731-886-1240
Practice Address - Fax:731-886-1234
Is Sole Proprietor?:No
Enumeration Date:2009-01-07
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN141802163W00000X
TN13938363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4220263OtherBCBS
MO1851537286Medicaid
TN1512968Medicaid
TN3342574Medicare UPIN
MO1851537286Medicaid