=====================================================
General NPI Number Information
=====================================================
NPI Number | 1326211939
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | HEATHER SUTHERLAND MILLER L.AC.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/04/2008
-----------------------------------------------------
Last Update Date | 04/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6240 KAHILIHOLO RD
-----------------------------------------------------
City | KILAUEA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96754-5123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-634-6320
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6240 KAHILIHOLO RD
-----------------------------------------------------
City | KILAUEA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96754-5123
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-631-0038
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 12280
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 1188
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------