Provider Demographics
NPI:1871573659
Name:MILLER, CHRISTINE MARIE (RN, MSN, APN, NP-C)
Entity type:Individual
Prefix:MS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, MSN, APN, NP-C
Other - Prefix:MS
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APN-NP-C
Mailing Address - Street 1:680 S ROCK BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-4113
Mailing Address - Country:US
Mailing Address - Phone:775-870-4333
Mailing Address - Fax:775-870-4633
Practice Address - Street 1:3915 NEIL RD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-6808
Practice Address - Country:US
Practice Address - Phone:775-870-4333
Practice Address - Fax:775-870-4633
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2015-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV000797363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV941196203OtherST. MARYS COMMUNITY CLINICS