Provider Demographics
NPI:1154154763
Name:MILLER, KIMBERLY E (RN)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:E
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 AUTUMNS WOOD CIR E
Mailing Address - Street 2:
Mailing Address - City:BRUNSWICK
Mailing Address - State:GA
Mailing Address - Zip Code:31525-5654
Mailing Address - Country:US
Mailing Address - Phone:386-871-7337
Mailing Address - Fax:
Practice Address - Street 1:2747 4TH ST # 101
Practice Address - Street 2:
Practice Address - City:BRUNSWICK
Practice Address - State:GA
Practice Address - Zip Code:31520-3714
Practice Address - Country:US
Practice Address - Phone:912-264-3236
Practice Address - Fax:912-264-0813
Is Sole Proprietor?:No
Enumeration Date:2024-08-21
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN301070163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health