Provider Demographics
NPI:1093505364
Name:MILLER, DEANNE
Entity type:Individual
Prefix:
First Name:DEANNE
Middle Name:
Last Name:MILLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:822 VICARS RDG
Mailing Address - Street 2:
Mailing Address - City:GANDEEVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25243-8440
Mailing Address - Country:US
Mailing Address - Phone:304-444-7838
Mailing Address - Fax:
Practice Address - Street 1:822 VICARS RDG
Practice Address - Street 2:
Practice Address - City:GANDEEVILLE
Practice Address - State:WV
Practice Address - Zip Code:25243-8440
Practice Address - Country:US
Practice Address - Phone:304-444-7838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-09
Last Update Date:2025-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant