Provider Demographics
NPI:1891931069
Name:MILLER, GARNETT (DNP FNP BC)
Entity Type:Individual
Prefix:MS
First Name:GARNETT
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DNP FNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1150 CASINO STRIP RESORT BLVD
Mailing Address - Street 2:
Mailing Address - City:ROBINSONVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38664
Mailing Address - Country:US
Mailing Address - Phone:662-357-7707
Mailing Address - Fax:662-357-7807
Practice Address - Street 1:1150 CASINO STRIP RESORT BLVD
Practice Address - Street 2:
Practice Address - City:ROBINSONVILLE
Practice Address - State:MS
Practice Address - Zip Code:38664
Practice Address - Country:US
Practice Address - Phone:662-357-7707
Practice Address - Fax:662-357-7807
Is Sole Proprietor?:No
Enumeration Date:2008-12-18
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012019851363LF0000X
TNAPN0000013748363LF0000X
MS810545363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily