Provider Demographics
NPI:1205491180
Name:MILLER, MICHELLE BUXTON (NP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:BUXTON
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 1:800 E CHEVES ST STE 350
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2649
Mailing Address - Country:US
Mailing Address - Phone:843-777-7555
Mailing Address - Fax:843-777-7563
Practice Address - Street 1:800 E CHEVES ST STE 350
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2649
Practice Address - Country:US
Practice Address - Phone:843-777-7555
Practice Address - Fax:843-777-7563
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22835363LA2100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care