Healthcare Provider Details

I. General information

NPI: 1750637252
Provider Name (Legal Business Name): LACHANA DENISE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2012
Last Update Date: 08/02/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3874 N SHERMAN DR
INDIANAPOLIS IN
46226-4462
US

IV. Provider business mailing address

3874 N SHERMAN DR
INDIANAPOLIS IN
46226-4462
US

V. Phone/Fax

Practice location:
  • Phone: 317-426-3481
  • Fax: 317-426-3481
Mailing address:
  • Phone: 317-426-3481
  • Fax: 317-426-3481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: