=====================================================
General NPI Number Information
=====================================================
NPI Number | 1538490511
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JANET PATRICIA MILLER M.S.N., R.N.C., N.P.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2010
-----------------------------------------------------
Last Update Date | 08/12/2013
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 72624 EL PASEO SUITE A1
-----------------------------------------------------
City | PALM DESERT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92260-3309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-346-3222
-----------------------------------------------------
Fax | 760-346-3234
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 72624 EL PASEO SUITE A1
-----------------------------------------------------
City | PALM DESERT
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92260-3309
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-614-7179
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LW0102X
-----------------------------------------------------
Taxonomy Name | Women's Health Nurse Practitioner
-----------------------------------------------------
License Number | 17003
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 17003
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------