Healthcare Provider Details

I. General information

NPI: 1922621572
Provider Name (Legal Business Name): ERIKA ANNE MILLER CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIKA ANNE ELLIS CRNA

II. Dates (important events)

Enumeration Date: 05/18/2020
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1710 HARPER RD
BECKLEY WV
25801-3357
US

IV. Provider business mailing address

76 PEACHTREE RD STE 300
ASHEVILLE NC
28803-3505
US

V. Phone/Fax

Practice location:
  • Phone: 304-256-4076
  • Fax:
Mailing address:
  • Phone: 828-398-5244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number106165
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: