Provider Demographics
NPI:1699426072
Name:MILLER, ELIZABETH ARLENE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ARLENE
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 1:471 HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-4606
Mailing Address - Country:US
Mailing Address - Phone:681-404-2677
Mailing Address - Fax:
Practice Address - Street 1:471 HAMPTON RD
Practice Address - Street 2:
Practice Address - City:FAIRMONT
Practice Address - State:WV
Practice Address - Zip Code:26554-4606
Practice Address - Country:US
Practice Address - Phone:681-404-2677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant