Healthcare Provider Details

I. General information

NPI: 1407339377
Provider Name (Legal Business Name): ALEXA S. MILLER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2018
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

90 S COMMERCE WAY STE 100
BETHLEHEM PA
18017-8611
US

IV. Provider business mailing address

90 S COMMERCE WAY STE 100
BETHLEHEM PA
18017-8611
US

V. Phone/Fax

Practice location:
  • Phone: 484-820-0260
  • Fax:
Mailing address:
  • Phone: 484-820-0260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberMA061662
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA061662
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberC5-0001250
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: