Provider Demographics
NPI:1962460287
Name:MILLER, STACY ANN (FNP)
Entity Type:Individual
Prefix:
First Name:STACY
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 760
Mailing Address - Street 2:EMERGENCY MEDICINE ASSOCIATES PC
Mailing Address - City:KITTANNING
Mailing Address - State:PA
Mailing Address - Zip Code:16201
Mailing Address - Country:US
Mailing Address - Phone:800-777-2455
Mailing Address - Fax:610-617-6280
Practice Address - Street 1:ONE NOLTE DRIVE
Practice Address - Street 2:ARMSTRONG COUNTY MEMORIAL HOSPITAL
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201
Practice Address - Country:US
Practice Address - Phone:724-543-8109
Practice Address - Fax:724-543-8809
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAVP006645B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA055994Medicare ID - Type Unspecified
P53620Medicare UPIN