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General NPI Number Information
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NPI Number | 1023387669
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Entity Type | Individual
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Provider Name | ANDREA L MILLER MS, RD
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Gender | Female
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Dates
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Enumeration Date | 12/28/2011
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 3200 INGLEWOOD AVE S APT 132
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-4168
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Country | US
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Telephone | 206-619-7366
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 INGLEWOOD AVE S APT 132
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-4168
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Country | US
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Telephone | 206-619-7366
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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 | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1083363
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 1083363
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License Number State | WA
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