Provider Demographics
NPI:1235017971
Name:MILLER, KELLY (PHD)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 GLENBROOK WAY # 1116
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-1230
Mailing Address - Country:US
Mailing Address - Phone:615-431-1635
Mailing Address - Fax:
Practice Address - Street 1:1012 GLENBROOK WAY # 1116
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-1230
Practice Address - Country:US
Practice Address - Phone:615-431-1635
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No174H00000XOther Service ProvidersHealth Educator