Miller, Credonna L

Miller, Credonna L is an individual health care provider with primary practice located at 5 Medical Park Dr Ste 101, Benton AR 72015-3729. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Miller, Credonna L can be contacted via phone (501) 778-3868.

Contact Information

Primary practice address
5 Medical Park Dr Ste 101 Benton AR 72015-3729
Phone: (501) 778-3868
Fax: (501) 317-1704
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Audiologist 231H00000X A#90 Arkansas

Profile Details

NPI number 1063487288
LBN Legal business name Miller, Credonna L
Credentials AUD
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Nov 3rd, 2011 - about 15 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 1063487288 NPPES
Arkansas MEDICAID 131885720
Arkansas Other 621697738

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