Individual provider · Type 1 NPI
Kristine Ericksen-Miller, NP
Primary Care Nurse Practitioner · Newport Beach, CA
NPI number
1174079115
Active
Practice location
4321 Birch St Ste 100
Newport Beach, CA 92660-1940
Mailing address
11921 Carmel Creek Rd Apt 129
San Diego, CA 92130-2585
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 95004881 (CA) |
| Primary Care Nurse Practitioner Primary | 363LP2300X | 95004881 (CA) |
Primary Care Nurse Practitioner: Definition to come...
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About NPI 1174079115
Kristine Ericksen-Miller, NP's National Provider Identifier is 1174079115, issued on Aug 30, 2016. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Newport Beach, CA. The record was last updated on Oct 16, 2018.