Healthcare Provider Details

I. General information

NPI: 1265222764
Provider Name (Legal Business Name): ALTHEA J MILLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALTHEA J BEACHY RN

II. Dates (important events)

Enumeration Date: 05/08/2025
Last Update Date: 05/08/2025
Certification Date: 05/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HAWKINS DR
IOWA CITY IA
52242-1009
US

IV. Provider business mailing address

1641 DERWEN DR
IOWA CITY IA
52246-4925
US

V. Phone/Fax

Practice location:
  • Phone: 319-356-8810
  • Fax:
Mailing address:
  • Phone: 319-330-5541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0200X
TaxonomyOncology Registered Nurse
License Number108832
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: