MEDICARE: CHRISTALENA 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	374U00000X	Home Health Aide		MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1720946106
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTALENA MILLER

Provider Business Mailing Address
First Line	:	7416 78TH AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55445-2755
Country	:	US
Telephone Number	:	763-442-9523
Fax Number	:	763-442-9523

Provider Business Practice Location Address
First Line	:	7416 78TH AVE N
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55445-2755
Country	:	US
Telephone Number	:	763-442-9523
Fax Number	:	763-442-9523

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

Provider Enumeration Date	:	01/13/2026
Last Update Date	:	01/13/2026

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