Healthcare Provider Details

I. General information

NPI: 1710263546
Provider Name (Legal Business Name): JULIE MILLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2011
Last Update Date: 10/25/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 DELAWARE RD
BUFFALO NY
14217-2445
US

IV. Provider business mailing address

155 DELAWARE RD
BUFFALO NY
14217-2445
US

V. Phone/Fax

Practice location:
  • Phone: 716-874-8403
  • Fax: 716-874-8650
Mailing address:
  • Phone: 716-874-8403
  • Fax: 716-874-8650

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number4558181
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: