=====================================================
General NPI Number Information
=====================================================
NPI Number | 1740191980
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | AMANDA LEIGH MILLER LPN
-----------------------------------------------------
Gender |
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/16/2026
-----------------------------------------------------
Last Update Date | 09/16/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 953 W PULASKI HWY
-----------------------------------------------------
City | ELKTON
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 21921-4714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-485-6544
-----------------------------------------------------
Fax | 443-485-6442
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 103 MARYLAND AVE
-----------------------------------------------------
City | WILMINGTON
-----------------------------------------------------
State | DE
-----------------------------------------------------
Zip | 19804-3057
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 443-485-6544
-----------------------------------------------------
Fax | 443-485-6442
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 164W00000X
-----------------------------------------------------
Taxonomy Name | Licensed Practical Nurse
-----------------------------------------------------
License Number | L2-0010767
-----------------------------------------------------
License Number State | DE
-----------------------------------------------------