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NPI Code Detail

MEDICARE: MRS. CARRIE D MILLER M.S.,CCC-A

MEDICARE: MRS. CARRIE D MILLER M.S.,CCC-A
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
1237600000XAudiologist-Hearing Aid Fitter2101001383VA
2231H00000XAudiologist2201001156VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
30007926527OTHERVAAETNA
4297809OTHERVAMAMSI
5240052OTHERVAMAMSI
6384444OTHERVAANTHEM

General Provider Information

NPI Number : 1801972617
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CARRIE D MILLER M.S.,CCC-A
Provider Business Mailing Address
First Line : PO BOX 8310
Second Line :
City : ROANOKE
State : VA
Zip : 24014-0310
Country : US
Telephone Number : 540-345-3556
Fax Number : 540-342-2193
Provider Business Practice Location Address
First Line : 2030 COLONIAL AVE SW
Second Line :
City : ROANOKE
State : VA
Zip : 24015-3204
Country : US
Telephone Number : 540-343-0165
Fax Number : 540-345-4664
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2006
Last Update Date : 04/27/2023

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