Provider Demographics
NPI:1457532335
Name:MILLER, ROBIN ELAINE KENNEL (MS, LAT, ATC, CSCS)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:ELAINE KENNEL
Last Name:MILLER
Suffix:
Gender:F
Credentials:MS, LAT, ATC, CSCS
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:ELAINE
Other - Last Name:KENNEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, LAT, ATC, CSCS
Mailing Address - Street 1:PO BOX 458
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-0458
Mailing Address - Country:US
Mailing Address - Phone:828-216-4846
Mailing Address - Fax:
Practice Address - Street 1:4844 SUNSET FOREST CIR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-7831
Practice Address - Country:US
Practice Address - Phone:828-216-4846
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07892255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer