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General NPI Number Information
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NPI Number | 1609424233
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Entity Type | Individual
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Provider Name | KATELYN MARIE MILLER RPH
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Gender | Female
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Dates
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Enumeration Date | 08/27/2019
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 235 5TH AVE EXT
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City | GLOVERSVILLE
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State | NY
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Zip | 12078-1814
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Country | US
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Telephone | 518-725-6541
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Fax |
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Provider Business Mailing Address
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Address Line | 4 PADDOCKS CIR APT 2
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City | SARATOGA SPGS
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State | NY
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Zip | 12866-9515
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Country | US
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Telephone |
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 065823
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License Number State | NY
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