Miller, Terry Wayne
Miller, Terry Wayne is an individual health care provider with primary practice located at 903 Mississippi Dr , Tupelo MS 38804-0928. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as his primary health care specialty. Miller, Terry Wayne can be contacted via phone (662) 377-4652.Contact Information
Primary practice address
903 Mississippi Dr
Tupelo MS 38804-0928
Phone: (662) 377-4652
Fax: (662) 377-4656
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R850611 | Mississippi |
Profile Details
| NPI number | 1740249515 |
|---|---|
| LBN Legal business name | Miller, Terry Wayne |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 21st, 2006 |
| Last updated | Dec 19th, 2016 - about 8 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 | 1740249515 | NPPES |
| Mississippi | MEDICAID | 00120504 |
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