Provider Demographics
NPI:1952397234
Name:MILLER, JANE JERNIGAN (APRN BC FNP)
Entity Type:Individual
Prefix:MRS
First Name:JANE
Middle Name:JERNIGAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:APRN BC FNP
Other - Prefix:
Other - First Name:MARTHA
Other - Middle Name:JANE
Other - Last Name:COURTNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:321 PLEASANT PL
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-2212
Mailing Address - Country:US
Mailing Address - Phone:434-975-9912
Mailing Address - Fax:
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:UNIVERSITY OF VIRGINIA HEALTH SYSTEM
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-243-4849
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2012-08-16
Deactivation Date:2007-07-17
Deactivation Code:
Reactivation Date:2007-07-20
Provider Licenses
StateLicense IDTaxonomies
GA605919133V00000X
GA0971-0209174400000X
VA0024164858363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
P33506Medicare UPIN
007551C19Medicare PIN