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General NPI Number Information
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NPI Number | 1194470674
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Entity Type | Individual
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Provider Name | JEREMY MILLER RN
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Gender | Male
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Dates
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Enumeration Date | 02/14/2022
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 842 MACY AVE
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City | CHICO
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State | CA
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Zip | 95926-4022
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Country | US
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Telephone | 530-399-0467
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Fax | 530-399-0452
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Provider Business Mailing Address
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Address Line | 842 MACY AVE
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City | CHICO
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State | CA
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Zip | 95926-4022
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Country | US
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Telephone | 530-354-4258
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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 | 347C00000X
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Taxonomy Name | Private Vehicle
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 835027
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License Number State | CA
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