Healthcare Provider Details

I. General information

NPI: 1588518203
Provider Name (Legal Business Name): MRS. SARA ANN MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2026
Last Update Date: 02/21/2026
Certification Date: 02/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7838 GRAND CHAMPION ST
FULTON MD
20759-2627
US

IV. Provider business mailing address

7838 GRAND CHAMPION ST
FULTON MD
20759-2627
US

V. Phone/Fax

Practice location:
  • Phone: 301-706-6415
  • Fax:
Mailing address:
  • Phone: 301-706-6415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: