Provider Demographics
NPI:1396637625
Name:MILLER, JENNIFER L (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 LAUREL RD E
Mailing Address - Street 2:
Mailing Address - City:NOKOMIS
Mailing Address - State:FL
Mailing Address - Zip Code:34275-3226
Mailing Address - Country:US
Mailing Address - Phone:941-917-3131
Mailing Address - Fax:
Practice Address - Street 1:2600 LAUREL RD E
Practice Address - Street 2:
Practice Address - City:NOKOMIS
Practice Address - State:FL
Practice Address - Zip Code:34275-3226
Practice Address - Country:US
Practice Address - Phone:941-917-3131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-21
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS37828183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist