Provider Demographics
NPI:1780918573
Name:MILLER, SUZETTE (PMH-NP)
Entity type:Individual
Prefix:
First Name:SUZETTE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PMH-NP
Other - Prefix:
Other - First Name:SUZETTE
Other - Middle Name:
Other - Last Name:TRENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:181 ROY CAMPBELL DR
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-9407
Mailing Address - Country:US
Mailing Address - Phone:606-439-1316
Mailing Address - Fax:606-439-8457
Practice Address - Street 1:102 MEDICAL CENTER DR
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-9421
Practice Address - Country:US
Practice Address - Phone:606-439-1331
Practice Address - Fax:606-439-6701
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3006201363LP0808X
KY6201P363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health