MEDICARE: WENDY A MILLER CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	0024162373	VA

General Provider Information

NPI Number	:	1497756191
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WENDY A MILLER CRNA

Provider Business Mailing Address
First Line	:	1602 SKIPWITH RD
Second Line	:
City	:	RICHMOND
State	:	VA
Zip	:	23229-5205
Country	:	US
Telephone Number	:	804-289-4937
Fax Number	:	804-565-6600

Provider Business Practice Location Address
First Line	:	13801 ST FRANCIS BLVD
Second Line	:	SUITE 200
City	:	MIDLOTHIAN
State	:	VA
Zip	:	23114-3206
Country	:	US
Telephone Number	:	804-270-1305
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2005
Last Update Date	:	03/24/2015

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