Healthcare Provider Details

I. General information

NPI: 1184553976
Provider Name (Legal Business Name): ANGELA MILLER
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2026
Last Update Date: 05/18/2026
Certification Date: 05/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 WHITE OAK ST SE
SAINT ALBANS WV
25177-9568
US

IV. Provider business mailing address

410 WHITE OAK ST SE
SAINT ALBANS WV
25177-9568
US

V. Phone/Fax

Practice location:
  • Phone: 681-205-9767
  • Fax:
Mailing address:
  • Phone: 681-205-9767
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: