Provider Demographics
NPI:1285492652
Name:MILLER, TONYA JEAN (RN,BSN)
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:JEAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:380 BUTTERFLY GARDENS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-7508
Mailing Address - Country:US
Mailing Address - Phone:614-722-5902
Mailing Address - Fax:614-938-8555
Practice Address - Street 1:380 BUTTERFLY GARDENS DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-7508
Practice Address - Country:US
Practice Address - Phone:614-722-5902
Practice Address - Fax:614-938-8555
Is Sole Proprietor?:No
Enumeration Date:2024-03-11
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH360890163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management