Miller, Renae L
Miller, Renae L is an individual health care provider with primary practice located at 1361 Wenner Rd , Detroit Lakes MN 56501-7918. 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, Renae L can be contacted via phone (218) 396-6500.Contact Information
Primary practice address
1361 Wenner Rd
Detroit Lakes MN 56501-7918
Phone: (218) 396-6500
Fax: (218) 396-6504
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 9386 | Minnesota |
Profile Details
| NPI number | 1669523718 |
|---|---|
| LBN Legal business name | Miller, Renae L |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 16th, 2007 |
| Last updated | Nov 28th, 2023 - about 2 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 | 1669523718 | NPPES |
| Minnesota | Other | 9386 | STATE OF MN PA LICENSE |
| Minnesota | Other | 1033355 | STATE OF MN PA LICENSE |
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