Healthcare Provider Details

I. General information

NPI: 1992705941
Provider Name (Legal Business Name): BARBARA R MILLER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2005
Last Update Date: 01/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2617 SHEFFIELD DR NEW RIVER DERMATOLOGY
BLACKSBURG VA
24060-8271
US

IV. Provider business mailing address

2617 SHEFFIELD DR
BLACKSBURG VA
24060-8271
US

V. Phone/Fax

Practice location:
  • Phone: 540-953-2210
  • Fax: 540-951-9112
Mailing address:
  • Phone: 540-953-2210
  • Fax: 540-951-9112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0017137391
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: