Basic Information
| Provider Information | |||||||||
| NPI: | 1154860765 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | ELIZABETH | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2650 E SHOW LOW LAKE RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | SHOW LOW | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 859017955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9285326900 | ||||||||
| FaxNumber: | 2853296019 | ||||||||
| Practice Location | |||||||||
| Address1: | 2650 E SHOW LOW LAKE RD STE 1 | ||||||||
| Address2: | |||||||||
| City: | SHOW LOW | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 859017955 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9285374300 | ||||||||
| FaxNumber: | 9285374320 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2017 | ||||||||
| LastUpdateDate: | 11/14/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 32542.1595 | WY | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | AP10893 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.