Healthcare Provider Details

I. General information

NPI: 1831046846
Provider Name (Legal Business Name): TIA DUDLEY MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2026
Last Update Date: 03/11/2026
Certification Date: 03/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1526 E MEDICAL CENTER DR
ST. GEORGE UT
84790
US

IV. Provider business mailing address

1180 S 4250 W
CEDAR CITY UT
84720-6235
US

V. Phone/Fax

Practice location:
  • Phone: 435-652-7500
  • Fax:
Mailing address:
  • Phone: 801-615-1469
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: