Provider Demographics
NPI:1942256185
Name:MILLER, ELIZABETH FRANCES (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:FRANCES
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E CHICAGO ST
Mailing Address - Street 2:
Mailing Address - City:JONESVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49250-1197
Mailing Address - Country:US
Mailing Address - Phone:517-849-9090
Mailing Address - Fax:517-849-9970
Practice Address - Street 1:100 E CHICAGO ST
Practice Address - Street 2:
Practice Address - City:JONESVILLE
Practice Address - State:MI
Practice Address - Zip Code:49250-1197
Practice Address - Country:US
Practice Address - Phone:517-849-9090
Practice Address - Fax:517-849-9970
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2011-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704139331363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4354777Medicaid
MI500023600OtherRR MEDICARE
MI500023600OtherRR MEDICARE
MI0N43670Medicare ID - Type UnspecifiedWA FOOTE MEMORIAL