Provider Demographics
NPI:1912142688
Name:MILLER, DONNA GAIL
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:GAIL
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:PO BOX 84
Mailing Address - Street 2:
Mailing Address - City:FARMERSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75442-0084
Mailing Address - Country:US
Mailing Address - Phone:903-776-2690
Mailing Address - Fax:
Practice Address - Street 1:2433 CR 1121
Practice Address - Street 2:
Practice Address - City:FARMERSVILLE
Practice Address - State:TX
Practice Address - Zip Code:75442
Practice Address - Country:US
Practice Address - Phone:903-776-2690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No172V00000XOther Service ProvidersCommunity Health Worker