Healthcare Provider Details

I. General information

NPI: 1538131081
Provider Name (Legal Business Name): ALLYN SARA MILLER - JAMES CRNA, MSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2006
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 COURTENAY DR
CHARLESTON SC
29425-3269
US

IV. Provider business mailing address

1012 PARKWAY DR
READING PA
19605-3269
US

V. Phone/Fax

Practice location:
  • Phone: 437-922-3008
  • Fax:
Mailing address:
  • Phone: 412-963-1252
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number21405
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN356811L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: