Healthcare Provider Details
I. General information
NPI: 1982843009
Provider Name (Legal Business Name): MONICA LEE MILLER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 02/12/2009
Last Update Date: 02/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
289 NORTH AVE
WASHINGTON PA
15301-3512
US
IV. Provider business mailing address
289 NORTH AVE
WASHINGTON PA
15301-3512
US
V. Phone/Fax
- Phone: 724-223-7801
- Fax: 724-223-7802
- Phone: 724-223-7801
- Fax: 724-223-7802
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WP0200X |
| Taxonomy | Pediatric Registered Nurse |
| License Number | RN599626 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: