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General NPI Number Information
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NPI Number | 1316859267
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Entity Type | Individual
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Provider Name | ATHENA BRONWYN MILLER RN
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Gender | Female
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Dates
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Enumeration Date | 09/17/2026
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Last Update Date | 09/17/2026
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Provider Practice Location Address
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Address Line | 2221 MARTIN LUTHER KING JR WAY
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City | OAKLAND
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State | CA
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Zip | 94612-1318
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Country | US
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Telephone | 510-267-7887
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Fax | 510-267-7887
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Provider Business Mailing Address
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Address Line | 1421 LOUISIANA ST
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City | VALLEJO
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State | CA
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Zip | 94590-4619
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Country | US
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Telephone | 510-267-7887
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Fax | 510-267-7883
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 95069731
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License Number State | CA
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