Healthcare Provider Details

I. General information

NPI: 1598753337
Provider Name (Legal Business Name): LINDA E MILLER RN MSN CS APN
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/06/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 DERHAKE RD
FLORISSANT MO
63033-5823
US

IV. Provider business mailing address

810 DERHAKE RD
FLORISSANT MO
63033-5823
US

V. Phone/Fax

Practice location:
  • Phone: 314-388-5201
  • Fax: 636-230-0421
Mailing address:
  • Phone: 314-388-5201
  • Fax: 636-230-0421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberRN554563
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: