Healthcare Provider Details

I. General information

NPI: 1346451556
Provider Name (Legal Business Name): DEBORAH ALLEAN MILLER R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

888 ALLGOOD RD
DECATUR MS
39327-9414
US

IV. Provider business mailing address

888 ALLGOOD RD
DECATUR MS
39327-9414
US

V. Phone/Fax

Practice location:
  • Phone: 601-635-3595
  • Fax:
Mailing address:
  • Phone: 601-635-3595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR762153
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: