Healthcare Provider Details

I. General information

NPI: 1558661439
Provider Name (Legal Business Name): HEATHER RAI MILLER CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2010
Last Update Date: 01/25/2022
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 SHARON RD STE D
CIRCLEVILLE OH
43113-1498
US

IV. Provider business mailing address

5450 FRANTZ RD STE 360
DUBLIN OH
43016-4141
US

V. Phone/Fax

Practice location:
  • Phone: 740-420-8422
  • Fax: 740-420-6270
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP11744
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: