Jennifer Lee Miller, RN

Individual provider Active NPI School Registered Nurse · Williamson, NY

NPI 1104196658 · NPPES record last updated Dec 30, 2011

Key facts

NPI
1104196658
Entity type
Individual (NPI type 1)
Primary specialty
School Registered Nurse 163WS0200X
License
555175-1 (NY)
Practice address
4184 Miller St
Williamson, NY 14589-9713
Phone
(315) 589-9665
NPI assigned
Dec 30, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
555175-1NYMDSchool Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Williamson Central School District Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
School Registered Nurse 163WS0200X 555175-1 NY Yes

Addresses

Primary practice location

4184 Miller St
Williamson, NY 14589-9713

Mailing address

4184 Miller St
PO Box 900
Williamson, NY 14589-9713
Phone (315) 589-9665

Other identifiers

IdentifierTypeStateIssuer
01391079MedicaidNY

Other providers in Williamson, NY

All providers in Williamson, NY · School Registered Nurse in New York

Sources for this page

Verify at the official NPI Registry.