Healthcare Provider Details

I. General information

NPI: 1649500760
Provider Name (Legal Business Name): TIWANA L. MILLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: TIWANA GREEN

II. Dates (important events)

Enumeration Date: 01/12/2010
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 931
BEAR DE
19701-0931
US

IV. Provider business mailing address

PO BOX 931
BEAR DE
19701-0931
US

V. Phone/Fax

Practice location:
  • Phone: 302-276-8228
  • Fax: 302-838-0696
Mailing address:
  • Phone: 302-276-8228
  • Fax: 302-838-0696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0000682
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: