Provider Demographics
NPI:1346496668
Name:MILLER, ANDREA LEIGH
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:LEIGH
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 1:540 S FOREST ST
Mailing Address - Street 2:BUILDING 6 UNIT 104
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-8143
Mailing Address - Country:US
Mailing Address - Phone:515-451-1650
Mailing Address - Fax:
Practice Address - Street 1:700 COLORADO BLVD # 318
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-4084
Practice Address - Country:US
Practice Address - Phone:303-339-7404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-18
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN-187618163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse