Provider Demographics
NPI:1104443704
Name:MILLER, BRITTANY NICHOLE (NP-C)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:NICHOLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1173 PARKTOWN DR
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-5559
Mailing Address - Country:US
Mailing Address - Phone:912-270-1161
Mailing Address - Fax:
Practice Address - Street 1:1173 PARKTOWN DR
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-5559
Practice Address - Country:US
Practice Address - Phone:912-270-1161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN245073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily