Healthcare Provider Details

I. General information

NPI: 1841733706
Provider Name (Legal Business Name): VICTORIA MILLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

147 S 52ND PL
SPRINGFIELD OR
97478-6210
US

IV. Provider business mailing address

PO BOX 1517
PENDLETON OR
97801-0410
US

V. Phone/Fax

Practice location:
  • Phone: 541-746-1166
  • Fax: 541-393-1607
Mailing address:
  • Phone: 541-278-4332
  • Fax: 907-622-4674

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number10016495
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: