Healthcare Provider Details

I. General information

NPI: 1003254459
Provider Name (Legal Business Name): JAMEYAN MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2013
Last Update Date: 12/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7312 W CHEYENNE AVE SUITE 4
LAS VEGAS NV
89129-7428
US

IV. Provider business mailing address

7075 W GOWAN RD APT 1023
LAS VEGAS NV
89129-7432
US

V. Phone/Fax

Practice location:
  • Phone: 702-203-7504
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP-1567
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: