Provider Demographics
NPI:1285876227
Name:MILLER, CARLA KAY
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:KAY
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:PO BOX 303
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:MO
Mailing Address - Zip Code:63957-0303
Mailing Address - Country:US
Mailing Address - Phone:573-223-4169
Mailing Address - Fax:573-223-7691
Practice Address - Street 1:306 N 2ND ST
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:MO
Practice Address - Zip Code:63957-1301
Practice Address - Country:US
Practice Address - Phone:573-223-4169
Practice Address - Fax:573-223-7691
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other