Provider Demographics
NPI:1023070612
Name:MILLER, JILL A (ARNP)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 748817
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-8817
Mailing Address - Country:US
Mailing Address - Phone:813-286-0033
Mailing Address - Fax:813-282-1806
Practice Address - Street 1:700 CENTRAL AVE STE 400
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-3600
Practice Address - Country:US
Practice Address - Phone:727-895-1300
Practice Address - Fax:727-823-3494
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2163002363LX0001X
FLAPRN2163002363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP2163002OtherMEDICAL LICENSE NUMBER
FLU5924ZMedicare ID - Type Unspecified
FLS77936Medicare UPIN