Krista Marie Miller, RN

Individual provider Active NPI Registered Nurse · Port Allen, LA

NPI 1154983997 · NPPES record last updated Jul 2, 2019

Key facts

NPI
1154983997
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
204834 (LA)
Practice address
203 Allendale Dr
Port Allen, LA 70767-3219
Phone
(225) 389-1311
Fax
(225) 683-1310
NPI assigned
Jul 2, 2019
Sex
Female
Sole proprietor
No

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
204834LAMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 204834 LA Yes

Addresses

Primary practice location

203 Allendale Dr
Port Allen, LA 70767-3219

Mailing address

PO Box 395
Clinton, LA 70722-0395
Phone (225) 683-5292

Other identifiers

IdentifierTypeStateIssuer
204834OtherLASTATE LICENSE

Other providers in Port Allen, LA

All providers in Port Allen, LA · Registered Nurse in Louisiana

Sources for this page

Verify at the official NPI Registry.