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NPI 1336232842

NPI 1336232842 : VANN MILLER CRNA : KAILUA, HI

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General NPI Number Information
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    NPI Number           |    1336232842
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    Entity Type          |    Individual 
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    Provider Name        |    VANN MILLER CRNA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    10/02/2006
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    Last Update Date     |    02/11/2008
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Provider Practice Location Address
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    Address Line         |    640 ULUKAHIKI ST 
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    City                 |    KAILUA
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    State                |    HI
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    Zip                  |    96734-4454
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    Country              |    US
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    Telephone            |    808-263-5500
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    BOX 1840 
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    City                 |    KAILUA KONA
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    State                |    HI
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    Zip                  |    96745-1840
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    Country              |    US
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    Telephone            |    808-325-6760
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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        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    APRN898
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    License Number State |    HI
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