Healthcare Provider Details

I. General information

NPI: 1124498365
Provider Name (Legal Business Name): VALERIE MILLER DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2015
Last Update Date: 03/10/2020
Certification Date: 03/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 E ELM ST
ALBION IL
62806
US

IV. Provider business mailing address

1418 COLLEGE DR
MOUNT CARMEL IL
62863-2638
US

V. Phone/Fax

Practice location:
  • Phone: 618-445-8170
  • Fax: 618-445-8175
Mailing address:
  • Phone: 618-262-8621
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209013385
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: