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General NPI Number Information
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NPI Number | 1104037530
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Entity Type | Individual
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Provider Name | SANDIE LYNN MILLER R.N.
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Gender | Female
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Dates
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Enumeration Date | 05/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | WARD DR
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City | SANTA BARBARA
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State | CA
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Zip | 93106-1000
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Country | US
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Telephone | 805-893-3594
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Fax |
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Provider Business Mailing Address
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Address Line | 350 PASEO DEL PINON
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City | GOLETA
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State | CA
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Zip | 93117-1000
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Country | US
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Telephone | 805-685-8737
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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 | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number | 148586
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License Number State | CA
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