MEDICARE: BARBARA MILLER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	L2380954	MI

General Provider Information

NPI Number	:	1407283831
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA MILLER

Provider Business Mailing Address
First Line	:	8033 E. TEN MILE RD
Second Line	:
City	:	CENTERLINE
State	:	MI
Zip	:	48015
Country	:	US
Telephone Number	:	586-756-6661
Fax Number	:	586-756-6933

Provider Business Practice Location Address
First Line	:	8033 E. TEN MILE RD
Second Line	:
City	:	CENTERLINE
State	:	MI
Zip	:	48015
Country	:	US
Telephone Number	:	586-756-6661
Fax Number	:	586-756-6933

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/30/2013
Last Update Date	:	09/30/2013

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Directions to “ BARBARA MILLER ” Practice Location

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