Miller, Jerome Timothy

Miller, Jerome Timothy is an individual health care provider with primary practice located at 2414 Kohler Memorial Dr , Sheboygan WI 53081-3129. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Miller, Jerome Timothy can be contacted via phone (920) 457-4461.

Contact Information

Primary practice address
2414 Kohler Memorial Dr Sheboygan WI 53081-3129
Phone: (920) 457-4461
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 726-23 Wisconsin

Profile Details

NPI number 1629034798
LBN Legal business name Miller, Jerome Timothy
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 26th, 2006
Last updated Jul 21st, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629034798 NPPES
Wisconsin MEDICAID 1629034798

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