MEDICARE: MISS RAQUEL MARGARITA MILLER RN

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	374U00000X	Home Health Aide		WI
2	172A00000X	Driver		WI

General Provider Information

NPI Number	:	1801023338
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS RAQUEL MARGARITA MILLER RN

Provider Business Mailing Address
First Line	:	2824 S 33RD ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-5203
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2824 S 33RD ST
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53215-5203
Country	:	US
Telephone Number	:	414-645-9912
Fax Number	:

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

Provider Enumeration Date	:	06/11/2009
Last Update Date	:	03/07/2014

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