Provider Demographics
NPI:1174405526
Name:MILLER, GINA RENEE
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:RENEE
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 1:2330 MARION BARRY AVE SE APT 616
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-4163
Mailing Address - Country:US
Mailing Address - Phone:200-400-4001
Mailing Address - Fax:
Practice Address - Street 1:222 M ST SW APT 109
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20024-3736
Practice Address - Country:US
Practice Address - Phone:202-652-5191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant