Provider Demographics
NPI:1720720253
Name:MILLER, LYNDEE ANN (PA-C)
Entity type:Individual
Prefix:
First Name:LYNDEE
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:LYNDEE
Other - Middle Name:ANN
Other - Last Name:HOOPES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5708 S ARRON LN
Mailing Address - Street 2:
Mailing Address - City:SAINT GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-2736
Mailing Address - Country:US
Mailing Address - Phone:208-501-3146
Mailing Address - Fax:
Practice Address - Street 1:292 S 1470 E STE 100
Practice Address - Street 2:
Practice Address - City:SAINT GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-1764
Practice Address - Country:US
Practice Address - Phone:435-628-9200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-13
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant