Miller, Jerry L.
Miller, Jerry L. is an sole proprietor health care provider with primary practice located at 930 Cambridge St Ste 107 , Fayetteville NC 28303-5356. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Miller, Jerry L. can be contacted via phone (910) 433-2307.Contact Information
Primary practice address
930 Cambridge St Ste 107
Fayetteville NC 28303-5356
Phone: (910) 433-2307
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 945 | North Carolina |
Profile Details
| NPI number | 1235257288 |
|---|---|
| LBN Legal business name | Miller, Jerry L. |
| Credentials | Master of Arts (MA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 27th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1235257288 | NPPES |
| North Carolina | MEDICAID | 6107454 |
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