Provider Demographics
NPI:1962503011
Name:MILLER, KRISTINE (NP)
Entity Type:Individual
Prefix:MS
First Name:KRISTINE
Middle Name:
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 1:1611 ZIMMERMAN TRAIL
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-1611
Mailing Address - Country:US
Mailing Address - Phone:406-248-3609
Mailing Address - Fax:406-248-8919
Practice Address - Street 1:1611 ZIMMERMAN TRAIL
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-1611
Practice Address - Country:US
Practice Address - Phone:406-248-3609
Practice Address - Fax:406-248-8919
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2011-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTAPN12026363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT37281OtherBCBS
MT4306055Medicaid
MT37281OtherBCBS
S60383Medicare UPIN