Provider Demographics
NPI:1316736523
Name:MILLER, KELYA MARIE (PHLEBOTOMIST)
Entity type:Individual
Prefix:
First Name:KELYA
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:
Credentials:PHLEBOTOMIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 BRETT DR # CONDO151
Mailing Address - Street 2:
Mailing Address - City:HINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31313-4239
Mailing Address - Country:US
Mailing Address - Phone:912-532-8088
Mailing Address - Fax:
Practice Address - Street 1:910 BRETT DR # CONDO151
Practice Address - Street 2:
Practice Address - City:HINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:31313-4239
Practice Address - Country:US
Practice Address - Phone:912-532-8088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-05
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA246Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Q00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Pathology