Provider Demographics
NPI:1427300805
Name:MILLER, ALLISON RANEE' (FNP-C)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:RANEE'
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:RANEE'
Other - Last Name:VARNUM-MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:245 GOAT ROCK RD
Mailing Address - Street 2:
Mailing Address - City:FORTSON
Mailing Address - State:GA
Mailing Address - Zip Code:31808-4023
Mailing Address - Country:US
Mailing Address - Phone:406-590-0590
Mailing Address - Fax:
Practice Address - Street 1:5448 WHITTLESEY BLVD STE B
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-7298
Practice Address - Country:US
Practice Address - Phone:706-225-5681
Practice Address - Fax:706-321-7118
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN224930363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily