Healthcare Provider Details

I. General information

NPI: 1659467611
Provider Name (Legal Business Name): ANA M MILLER RN, CWOCN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 ROCK ISLAND ARSENAL
ROCK ISLAND IL
61299-7530
US

IV. Provider business mailing address

40294 PINEWOOD CT
BROWERVILLE MN
56438-4598
US

V. Phone/Fax

Practice location:
  • Phone: 309-782-6950
  • Fax:
Mailing address:
  • Phone: 218-821-5488
  • Fax: 309-782-1368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WW0000X
TaxonomyWound Care Registered Nurse
License NumberR 121 849 3
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: