Provider Demographics
NPI:1831515998
Name:MILLER, KRISTEN BENNETT (RN, MSN)
Entity type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:BENNETT
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 LYNDALE DR
Mailing Address - Street 2:
Mailing Address - City:HARTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29550-4613
Mailing Address - Country:US
Mailing Address - Phone:843-673-6536
Mailing Address - Fax:843-661-4859
Practice Address - Street 1:145 E CHEVES ST
Practice Address - Street 2:PEE DEE PUBLIC HEALTH REGION
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2526
Practice Address - Country:US
Practice Address - Phone:843-661-4830
Practice Address - Fax:843-661-4859
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC96128163WC0400X, 163WC1500X, 163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator