Miller, Judith L

Miller, Judith L is an individual health care provider with primary practice located at 4695 Shoreline Dr , Spring Park MN 55384-9715. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Gerontology, which is considered as her primary health care specialty. Miller, Judith L can be contacted via phone (952) 442-7890.

Contact Information

Primary practice address
4695 Shoreline Dr Spring Park MN 55384-9715
Phone: (952) 442-7890
Fax: (952) 442-7893
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X R0732886 Minnesota

Profile Details

NPI number 1306845243
LBN Legal business name Miller, Judith L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated May 13th, 2008 - about 18 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 1306845243 NPPES
Minnesota MEDICAID 412726900
Minnesota Other R0732886

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