Provider Demographics
NPI:1417836917
Name:MILLER, JORDYN LYNN
Entity type:Individual
Prefix:
First Name:JORDYN
Middle Name:LYNN
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JORDYN
Other - Middle Name:LYNN
Other - Last Name:KINCADE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:633 N EAST ST
Mailing Address - Street 2:
Mailing Address - City:NEW AUBURN
Mailing Address - State:WI
Mailing Address - Zip Code:54757-8505
Mailing Address - Country:US
Mailing Address - Phone:715-944-7674
Mailing Address - Fax:
Practice Address - Street 1:2050 LEXINGTON RD
Practice Address - Street 2:
Practice Address - City:VERSAILLES
Practice Address - State:KY
Practice Address - Zip Code:40383-1738
Practice Address - Country:US
Practice Address - Phone:859-251-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2531050163WX0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0003XNursing Service ProvidersRegistered NurseObstetric, Inpatient