Provider Demographics
NPI:1124498365
Name:MILLER, VALERIE (DNP)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1418 COLLEGE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT CARMEL
Mailing Address - State:IL
Mailing Address - Zip Code:62863-2638
Mailing Address - Country:US
Mailing Address - Phone:618-262-8621
Mailing Address - Fax:
Practice Address - Street 1:26 E ELM ST
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:IL
Practice Address - Zip Code:62806
Practice Address - Country:US
Practice Address - Phone:618-445-8170
Practice Address - Fax:618-445-8175
Is Sole Proprietor?:No
Enumeration Date:2015-09-30
Last Update Date:2020-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209013385363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL209013385OtherILLINOIS ADVANCED PRACTICE NURSE LICENSE