Provider Demographics
NPI:1326211939
Name:MILLER, HEATHER SUTHERLAND (LAC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:SUTHERLAND
Last Name:MILLER
Suffix:
Gender:
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6240 KAHILIHOLO RD
Mailing Address - Street 2:
Mailing Address - City:KILAUEA
Mailing Address - State:HI
Mailing Address - Zip Code:96754-5123
Mailing Address - Country:US
Mailing Address - Phone:808-631-0038
Mailing Address - Fax:
Practice Address - Street 1:6240 KAHILIHOLO RD
Practice Address - Street 2:
Practice Address - City:KILAUEA
Practice Address - State:HI
Practice Address - Zip Code:96754-5123
Practice Address - Country:US
Practice Address - Phone:808-634-6320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-04
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12280171100000X
HI1188171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturist