Provider Demographics
NPI:1548321243
Name:MILLER, SUZANNE (NURSE PRACTIONER)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 E COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37091-3340
Mailing Address - Country:US
Mailing Address - Phone:931-270-7888
Mailing Address - Fax:931-270-7882
Practice Address - Street 1:122 E COMMERCE ST
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:TN
Practice Address - Zip Code:37091-3340
Practice Address - Country:US
Practice Address - Phone:931-270-7888
Practice Address - Fax:931-270-7882
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7084363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4064585Medicaid
TNS73978Medicare UPIN
TN3718816Medicare ID - Type Unspecified