Healthcare Provider Details

I. General information

NPI: 1023260452
Provider Name (Legal Business Name): RAINI L. MILLER BSN, RN-BC, CSAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2008
Last Update Date: 08/29/2018
Certification Date:
Deactivation Date: 02/16/2012
Reactivation Date: 08/29/2018

III. Provider practice location address

459 PATTERSON ROAD VA PACIFIC ISLANDS HEALTH CARE SYSTE
HONOLULU HI
96819-1522
US

IV. Provider business mailing address

459 PATTERSON ROAD VA PACIFIC ISLANDS HEALTH CARE SYSTE
HONOLULU HI
96819-1522
US

V. Phone/Fax

Practice location:
  • Phone: 808-538-2518
  • Fax: 808-839-1747
Mailing address:
  • Phone: 808-538-2518
  • Fax: 808-839-1747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number47601
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number47601
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number552162
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number47601
License Number StateHI
# 5
Primary TaxonomyY
Taxonomy Code163WP0807X
TaxonomyChild & Adolescent Psychiatric/Mental Health Registered Nurse
License Number47601
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: