Miller, Lisa M

Miller, Lisa M is an individual health care provider with primary practice located at 1116 Millis Ave Ste 101, Boonville IN 47601-2292. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Miller, Lisa M can be contacted via phone (812) 897-7107.

Contact Information

Primary practice address
1116 Millis Ave Ste 101 Boonville IN 47601-2292
Phone: (812) 897-7107
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 71001974A Indiana

Profile Details

NPI number 1942296009
LBN Legal business name Miller, Lisa M
Credentials FNP-C
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated Jul 26th, 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 1942296009 NPPES
Indiana MEDICAID 200303730
Indiana MEDICAID 78015146

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