Miller, Keri Long
Miller, Keri Long is an individual health care provider with primary practice located at 1165 Dunlawton Ave Ste 105 , Port Orange FL 32127-2924. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Miller, Keri Long can be contacted via phone (386) 425-4787.Contact Information
Primary practice address
1165 Dunlawton Ave Ste 105
Port Orange FL 32127-2924
Phone: (386) 425-4787
Fax: (386) 425-4788
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA 9108344 | Florida |
Profile Details
| NPI number | 1093111510 |
|---|---|
| LBN Legal business name | Miller, Keri Long |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 11th, 2014 |
| 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093111510 | NPPES |
| Florida | MEDICAID | 013803400 |
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