Healthcare Provider Details

I. General information

NPI: 1598382095
Provider Name (Legal Business Name): BRIANA APRIL MILLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2020
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 VICTORIA ST
COSTA MESA CA
92627-7131
US

IV. Provider business mailing address

8941 ATLANTA AVE # 106
HUNTINGTON BEACH CA
92646-7121
US

V. Phone/Fax

Practice location:
  • Phone: 949-642-2734
  • Fax:
Mailing address:
  • Phone: 714-928-8858
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1400X
TaxonomyCollege Health Registered Nurse
License Number1760962419
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: