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General NPI Number Information
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NPI Number | 1659441079
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Entity Type | Individual
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Provider Name | MISTI K MILLER R.PH.
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 09/28/2022
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Provider Practice Location Address
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Address Line | 1804 N CLINTON ST
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City | DEFIANCE
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State | OH
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Zip | 43512-8556
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Country | US
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Telephone | 419-784-2390
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Fax |
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Provider Business Mailing Address
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Address Line | 13154 ROAD 176
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City | PAULDING
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State | OH
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Zip | 45879-8829
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Country | US
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Telephone | 419-769-4002
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03118992
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-1-18992
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License Number State | OH
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