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General NPI Number Information
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NPI Number | 1013779834
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Entity Type | Individual
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Provider Name | HAZEL MILLER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 01/26/2024
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 6980 BRADDOCK RD
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City | ANNANDALE
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State | VA
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Zip | 22003
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Country | US
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Telephone | 703-333-6361
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Fax |
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Provider Business Mailing Address
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Address Line | 9906 FAIRFAX SQ APT 140
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City | FAIRFAX
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State | VA
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Zip | 22031-4206
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Country | US
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Telephone | 703-463-7007
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202221810
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License Number State | VA
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