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General NPI Number Information
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NPI Number | 1841830676
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Entity Type | Individual
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Provider Name | MERRY LORI MILLER
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Gender | Female
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Dates
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Enumeration Date | 01/09/2020
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Last Update Date | 01/09/2020
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Provider Practice Location Address
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Address Line | 217 S HOFSTETTER ST
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City | COLVILLE
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State | WA
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Zip | 99114-3239
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Country | US
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Telephone | 509-684-7840
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 235
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City | KETTLE FALLS
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State | WA
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Zip | 99141-0235
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | LP00051415
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License Number State | WA
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