Individual ProviderKourtney MillerRegistered NurseNursing Service ProvidersPractice Address2953 Bruner Ave, Bronx, NY 10469-3313(718) 671-0680PECOS EnrollmentBased on the most recent information from CMS, provider Kourtney Miller does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 7 days ago.Profile DetailsProvider ID1750901351Provider TypeIndividualFull NameMiller, KourtneyGenderFemaleSole ProprietorYesEnumeration Date4/23/2020Last Updated4/23/2020Contact InformationPractice LocationPractice Address2953 Bruner Ave, Bronx, NY 10469-3313Phone(718) 671-0680FaxUnlisted FaxMailing LocationMailing Address1308 Hicks St Apt 2a, Bronx, NY 10469-1736PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense745791New York