Provider Demographics
NPI:1427068204
Name:MILLER, DONNA JEAN (NPT)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:JEAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:NPT
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 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:310-272-8222
Mailing Address - Fax:
Practice Address - Street 1:9033 WILSHIRE BLVD STE 406
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-1847
Practice Address - Country:US
Practice Address - Phone:310-272-8222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11486363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3620590OtherBLUE SHIELD
CARN362059Medicaid
CA3620590OtherBLUE SHIELD
CA500016786OtherRAILROAD MEDICARE
CAW11675OtherGROUP MEDICARE PIN
CAW18762OtherGROUP MEDICARE
CA1356390009OtherGROUP NPI
CAGR0100430OtherGROUP MEDICAL
CARN362059Medicaid
CACE1617OtherGROUP RAILROAD MEDICARE
CAP25178Medicare UPIN
CAWNP11486AMedicare PIN