Provider Demographics
NPI:1285111377
Name:MILLER, JENNIFER E (CRNP)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:E
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 1:535 OLD WESTMINSTER PIKE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:MD
Mailing Address - Zip Code:21157-6267
Mailing Address - Country:US
Mailing Address - Phone:410-876-8332
Mailing Address - Fax:
Practice Address - Street 1:535 OLD WESTMINSTER PIKE STE 101
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-6267
Practice Address - Country:US
Practice Address - Phone:410-876-8332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-23
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR198908363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care