Provider Demographics
NPI:1912714429
Name:MILLER, ANNETTE ROSE (FNP)
Entity type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:ROSE
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:298 ORD ST
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:PA
Mailing Address - Zip Code:15558-9006
Mailing Address - Country:US
Mailing Address - Phone:859-414-0318
Mailing Address - Fax:
Practice Address - Street 1:915 BISHOP WALSH RD
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-1850
Practice Address - Country:US
Practice Address - Phone:301-777-2722
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR256803363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily