Healthcare Provider Details

I. General information

NPI: 1487435855
Provider Name (Legal Business Name): GERALDINE RENEE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GERI RENEE MILLER

II. Dates (important events)

Enumeration Date: 10/11/2023
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26151 LAKE SHORE BLVD APT 1124
EUCLID OH
44132-1155
US

IV. Provider business mailing address

26151 LAKE SHORE BLVD APT 1124
EUCLID OH
44132-1155
US

V. Phone/Fax

Practice location:
  • Phone: 469-540-0681
  • Fax: 216-245-1833
Mailing address:
  • Phone: 469-540-0681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberGRIMLLR
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH
# 6
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: