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General NPI Number Information
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NPI Number | 1225725575
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Entity Type | Individual
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Provider Name | LEEANNA MILLER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/18/2023
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Last Update Date | 04/18/2023
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Provider Practice Location Address
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Address Line | 210 BLACK GOLD BLVD STE 104
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City | HAZARD
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State | KY
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Zip | 41701-2620
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Country | US
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Telephone | 606-487-7380
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 719
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City | BONNYMAN
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State | KY
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Zip | 41719-0719
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Country | US
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Telephone | 606-438-3722
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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 | 20175
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License Number State | KY
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