Basic Information
| Provider Information | |||||||||
| NPI: | 1861766909 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | EMILY | ||||||||
| MiddleName: | JOY | ||||||||
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| Credential: | CRNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 694 GOOD DR STE 11 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176012433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175443737 | ||||||||
| FaxNumber: | 7175443739 | ||||||||
| Practice Location | |||||||||
| Address1: | 694 GOOD DR STE 11 | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | PA | ||||||||
| PostalCode: | 176012433 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7175443737 | ||||||||
| FaxNumber: | 7175443739 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/07/2012 | ||||||||
| LastUpdateDate: | 07/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | SP012396 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 363LW0102X | 26NJ00367000 | NJ | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health |
ID Information
| ID | Type | State | Issuer | Description | 1007278000 | 01 | PA | TPI GROUP MA | OTHER | CD4829 | 01 | PA | TPI GROUP RR MEDICARE | OTHER | 597586 | 01 | PA | TPI GROUP MEDICARE | OTHER |