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General NPI Number Information
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NPI Number | 1447036348
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Entity Type | Individual
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Provider Name | MAXINE CHRISTA MILLER AUD
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Gender | Female
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Dates
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Enumeration Date | 09/06/2023
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Last Update Date | 09/06/2023
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Provider Practice Location Address
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Address Line | 330 WARNER DR
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City | LEWISTON
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State | ID
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Zip | 83501-4441
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Country | US
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Telephone | 208-746-0193
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Fax | 208-746-7074
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Provider Business Mailing Address
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Address Line | 330 WARNER DR
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City | LEWISTON
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State | ID
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Zip | 83501-4441
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Country | US
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Telephone | 208-746-0193
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Fax | 208-746-7074
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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 | 237600000X
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Taxonomy Name | Audiologist-Hearing Aid Fitter
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License Number | AUD-1068
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License Number State | ID
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