Jessica Nicole Miller, LPN

Individual provider Active NPI Licensed Practical Nurse · Bainbridge, NY

NPI 1326437765 · NPPES record last updated Jan 22, 2015

Key facts

NPI
1326437765
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
318313-1 (NY)
Practice address
497 E Afton Rd
Bainbridge, NY 13733-3275
Phone
(607) 761-5117
NPI assigned
Jan 22, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
318313-1NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 318313-1 NY Yes

Addresses

Primary practice location

497 E Afton Rd
Bainbridge, NY 13733-3275

Mailing address

497 E Afton Rd
Bainbridge, NY 13733-3275
Phone (607) 761-5117

Other providers in Bainbridge, NY

All providers in Bainbridge, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.