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JANIS DEANN MILLER NP
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1356401335
Individual Registrant: JANIS DEANN MILLER NP
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
302 NORTH MILL STREET GREENUP, IL 62428 US
Tel: 217-923-3311 Fax: 217-923-5160
Tel: 217-923-3311 Fax: 217-923-5160
Contact information for business:
302 NORTH MILL STREET GREENUP, IL 62428 US
Tel: 217-923-3311 Fax: 217-923-5160
Tel: 217-923-3311 Fax: 217-923-5160
Registration Information:
NPI: 1356401335
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | IN | 71002505A |
| Y | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | IL | 2009006355 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| LICENSE | 209006355 | IL | 01 |
| RR MEDICARE | P00435500 | IN | 01 |
| 200876860 | IN | 05 |
