Healthcare Provider Details

I. General information

NPI: 1487859997
Provider Name (Legal Business Name): DAYNA JO MILLER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DAYNA JO DEPPING M.D.

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 02/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR DEPT OF PEDIATRICS
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

200 HAWKINS DR DEPT OF PEDIATRICS
IOWA CITY IA
52242-1009
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-1616
  • Fax:
Mailing address:
  • Phone: 319-356-1616
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberR-8055
License Number StateIA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number38897
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: