Provider Demographics
NPI:1992581128
Name:MILLER, SHOKEA (DNP, FNP)
Entity type:Individual
Prefix:DR
First Name:SHOKEA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 MOUNT MORIAH RD STE 25
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38115-1635
Mailing Address - Country:US
Mailing Address - Phone:901-506-0406
Mailing Address - Fax:
Practice Address - Street 1:5830 MOUNT MORIAH RD STE 25
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38115-1635
Practice Address - Country:US
Practice Address - Phone:901-506-0406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-05
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27249363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily