MEDICARE: MR. ANA M MILLER RN, CWOCN

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	163WW0000X	Wound Care Registered Nurse	R 121 849 3	MN

General Provider Information

NPI Number	:	1659467611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ANA M MILLER RN, CWOCN

Provider Business Mailing Address
First Line	:	40294 PINEWOOD CT
Second Line	:
City	:	BROWERVILLE
State	:	MN
Zip	:	56438-4598
Country	:	US
Telephone Number	:	218-821-5488
Fax Number	:	309-782-1368

Provider Business Practice Location Address
First Line	:	1 ROCK ISLAND ARSENAL
Second Line	:
City	:	ROCK ISLAND
State	:	IL
Zip	:	61299-7530
Country	:	US
Telephone Number	:	309-782-6950
Fax Number	:

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

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	07/08/2007

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