Provider Demographics
NPI:1700490703
Name:MILLER, KATHRYN
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7583 E LARKSPUR DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-4736
Mailing Address - Country:US
Mailing Address - Phone:480-773-0674
Mailing Address - Fax:
Practice Address - Street 1:145 INVERNESS DR E STE 350
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-5173
Practice Address - Country:US
Practice Address - Phone:720-870-7446
Practice Address - Fax:720-870-7460
Is Sole Proprietor?:No
Enumeration Date:2020-09-07
Last Update Date:2022-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant