Healthcare Provider Details

I. General information

NPI: 1861319352
Provider Name (Legal Business Name): CHRISTINA JO MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 BLACKLICK EASTERN RD
PICKERINGTON OH
43147-8235
US

IV. Provider business mailing address

109 W SMITH ST
HICKSVILLE OH
43526-1039
US

V. Phone/Fax

Practice location:
  • Phone: 614-726-7359
  • Fax: 740-907-0796
Mailing address:
  • Phone: 419-487-2728
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: