Provider Demographics
NPI:1346559895
Name:MILLER, KELLY D (APN)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:D
Last Name:MILLER
Suffix:
Gender:F
Credentials:APN
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Mailing Address - Street 1:921 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-2102
Mailing Address - Country:US
Mailing Address - Phone:423-209-8000
Mailing Address - Fax:423-209-8001
Practice Address - Street 1:9527 W RIDGE TRAIL RD
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-4018
Practice Address - Country:US
Practice Address - Phone:423-209-5490
Practice Address - Fax:423-498-4584
Is Sole Proprietor?:No
Enumeration Date:2010-10-01
Last Update Date:2024-11-15
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Provider Licenses
StateLicense IDTaxonomies
TNAPN0000015146363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology