Provider Demographics
NPI:1891774857
Name:MILLER, KAYE (C FNP)
Entity Type:Individual
Prefix:
First Name:KAYE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:C FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1520 WASHINGTON ST E
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-2511
Mailing Address - Country:US
Mailing Address - Phone:304-343-7000
Mailing Address - Fax:304-343-7009
Practice Address - Street 1:1520 WASHINGTON ST E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-2511
Practice Address - Country:US
Practice Address - Phone:304-343-7000
Practice Address - Fax:130-434-3700
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-10
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV36817363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001721074OtherMS BCBS
WV7103127000Medicaid
WV001721074OtherMS BCBS
2030622Medicare PIN
2030625Medicare PIN
2030621Medicare PIN
WVWV0752AMedicare PIN
2030626Medicare PIN
WVWV0752CMedicare PIN
P83303Medicare UPIN
2030627Medicare PIN
WVWV0752BMedicare PIN
2030623Medicare PIN