MEDICARE: MRS. DAKOTAH OLIVIA-GEORGE MILLER

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	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1689465130
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DAKOTAH OLIVIA-GEORGE MILLER

Provider Business Mailing Address
First Line	:	2807 WESTBROOK DR APT 103
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-2016
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2807 WESTBROOK DR APT 103
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46805-2016
Country	:	US
Telephone Number	:	260-739-9737
Fax Number	:

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

Provider Enumeration Date	:	05/14/2025
Last Update Date	:	05/19/2025

Similar Medicare Providers

1386699445 — ISD RENAL INC
Practice Location Address:

7017 S ANTHONY BLVD
FORT WAYNE, IN
46816-2016

Practice Phone: 260-447-2220
Practice Fax: 260-447-2044

1376727339 — GOLDEN HANDS TRANSPORTATION LLC.
Practice Location Address:

624 E WAYNE ST
FORT WAYNE, IN
46802-2016

Practice Phone: 260-557-7004
Practice Fax: 260-338-0584

1851318075 — WAL-MART STORES EAST LP
Practice Location Address:

2016 N WAYNE ST
ANGOLA, IN
46703-9102

Practice Phone: 260-665-7033
Practice Fax:

1205918430 — WAL-MART STORES EAST, LP
Practice Location Address:

2016 N WAYNE ST
ANGOLA, IN
46703-9102

Practice Phone: 260-665-7313
Practice Fax:

1093101867 — DENISE COLON
Practice Location Address:

8181 N WAYNE RD APT 2016
WESTLAND, MI
48185-1328

Practice Phone: 734-444-6873
Practice Fax:

1407453301 — CHRISTINA LOUISE STAYBACK
Practice Location Address:

2016 N WAYNE ST
ANGOLA, IN
46703-9102

Practice Phone: 260-665-7033
Practice Fax: 260-665-6831

Directions to “ MRS. DAKOTAH OLIVIA-GEORGE MILLER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.