Provider Demographics
NPI:1124502331
Name:MILLER, WENDY PAIGE (CRNP)
Entity type:Individual
Prefix:
First Name:WENDY
Middle Name:PAIGE
Last Name:MILLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:515 S 3RD ST
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35901-5301
Mailing Address - Country:US
Mailing Address - Phone:256-547-4971
Mailing Address - Fax:256-547-9755
Practice Address - Street 1:515 S 3RD ST
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5301
Practice Address - Country:US
Practice Address - Phone:256-547-4971
Practice Address - Fax:256-547-9755
Is Sole Proprietor?:No
Enumeration Date:2018-09-24
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-100566207QA0505X, 207KA0200X, 207QG0300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine