Healthcare Provider Details

I. General information

NPI: 1194809244
Provider Name (Legal Business Name): VELDA JUNE MILLER R.N,B.S.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DEPARTMENT OF VETERAN'S AFFAIRS PUGET SOUND HEALTH CAR AMERICAN LAKE DIVISION
TACOMA WA
98493-5000
US

IV. Provider business mailing address

6751 STEAMER DR SE
LACEY WA
98513-6223
US

V. Phone/Fax

Practice location:
  • Phone: 253-583-1115
  • Fax: 253-589-4028
Mailing address:
  • Phone: 360-413-7954
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN00121045
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: