Provider Demographics
NPI:1114749066
Name:MILLER, DANIELLE RENEE (AGACNP)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:RENEE
Last Name:MILLER
Suffix:
Gender:F
Credentials:AGACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31234 LAKESIDE DR
Mailing Address - Street 2:
Mailing Address - City:DELAND
Mailing Address - State:FL
Mailing Address - Zip Code:32720-7812
Mailing Address - Country:US
Mailing Address - Phone:717-247-9054
Mailing Address - Fax:
Practice Address - Street 1:31234 LAKESIDE DR
Practice Address - Street 2:
Practice Address - City:DELAND
Practice Address - State:FL
Practice Address - Zip Code:32720-7812
Practice Address - Country:US
Practice Address - Phone:717-247-9054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11036254363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care