Provider Demographics
NPI:1124679006
Name:MILLER, VIOLA YVONNE
Entity type:Individual
Prefix:
First Name:VIOLA
Middle Name:YVONNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5536 HIGHWAY 49 W
Mailing Address - Street 2:
Mailing Address - City:VANLEER
Mailing Address - State:TN
Mailing Address - Zip Code:37181-5058
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5536 HIGHWAY 49 W
Practice Address - Street 2:
Practice Address - City:VANLEER
Practice Address - State:TN
Practice Address - Zip Code:37181-5058
Practice Address - Country:US
Practice Address - Phone:615-763-0523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider