Provider Demographics
NPI:1699957530
Name:MILLER, DANIELLE K (RN)
Entity type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:K
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11301 WESLEY PROVIDENCE PKWY
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-6979
Mailing Address - Country:US
Mailing Address - Phone:404-510-2562
Mailing Address - Fax:
Practice Address - Street 1:11301 WESLEY PROVIDENCE PKWY
Practice Address - Street 2:
Practice Address - City:LITHONIA
Practice Address - State:GA
Practice Address - Zip Code:30038-6979
Practice Address - Country:US
Practice Address - Phone:404-510-2562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-03
Last Update Date:2007-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN166071163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn