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Jessica Ann Miller

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

35 Michigan St NE, Suite 4150, Grand Rapids, MI 49503-2514

PECOS Enrollment

This provider is enrolled in PECOS as JESSICA MILLER.

Based on the most recent information from CMS, provider Jessica Ann Miller is legally eligible to order and refer claims for DME and PMD services only.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 10:37 AM.

Profile Details

Provider ID
1942579057
Provider Type
Individual
Full Name
Miller, Jessica Ann
Credential
PA

Gender
Female
Sole Proprietor
No
Enumeration Date
12/19/2011
Last Updated
2/18/2021

Contact Information

Practice Location

35 Michigan St NE, Suite 4150, Grand Rapids, MI 49503-2514

(616) 267-2600

(616) 267-2601

Mailing Location

100 Michigan St NE, Mc 845, Grand Rapids, MI 49503-2560

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 5601006024 Michigan

Provider Identifiers

ID	Description	Issuer
ID 5601006024	Description Other	Issuer PA TASK FORCE Michigan

Jessica Ann Miller

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Bremer, Sarah Ruth

Schroeder, Adam Joseph

Loyd, Benjamin P

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Schoen, Kailey

Meeuwsen, Kyle Donovan

Magnusson, Michelle Lynn

Maatman, Caleb R

Adams, Christie Marie

Quinnan, Anna Noelle