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NPI 1477752392

NPI 1477752392 : VIRGINIA LEE MILLER NP : MODESTO, CA

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General NPI Number Information
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    NPI Number           |    1477752392
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    Entity Type          |    Individual 
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    Provider Name        |    VIRGINIA LEE MILLER NP
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    07/11/2007
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    Last Update Date     |    07/26/2007
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Provider Practice Location Address
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    Address Line         |    1431 MCHENRY AVE SUITE 100
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    City                 |    MODESTO
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    State                |    CA
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    Zip                  |    95350-4534
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    Country              |    US
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    Telephone            |    209-579-2300
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    Fax                  |    209-579-1948
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Provider Business Mailing Address
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    Address Line         |    1691 THE ALAMEDA 
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    City                 |    SAN JOSE
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    State                |    CA
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    Zip                  |    95126-2203
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    Country              |    US
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    Telephone            |    408-287-7532
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    Fax                  |    408-287-0405
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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        |    363LX0001X
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    Taxonomy Name        |    Obstetrics & Gynecology Nurse Practitioner
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    License Number       |    NP6310
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    License Number State |    CA
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