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General NPI Number Information
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NPI Number | 1760889141
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Entity Type | Organization
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Legal Business Name | ROXANNE MILLER
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 305 WOOD ST
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City | DELTA
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State | OH
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Zip | 43515-1115
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Country | US
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Telephone | 419-343-8264
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Fax |
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Provider Business Mailing Address
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Address Line | 305 WOOD ST
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City | DELTA
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State | OH
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Zip | 43515-1115
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Country | US
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Telephone | 419-343-8264
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Fax |
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Authorized Official
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Title or Position | LPN
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Name | ROXANNE MILLER
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Credential |
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Telephone | 419-343-8264
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | PN.146107-M-IV
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License Number State | OH
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