Provider Demographics
NPI:1962195834
Name:MILLER, TAYNA NICOLE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:TAYNA
Middle Name:NICOLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:576 KULAIWI DR
Mailing Address - Street 2:
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-1591
Mailing Address - Country:US
Mailing Address - Phone:772-999-1349
Mailing Address - Fax:
Practice Address - Street 1:576 KULAIWI DR
Practice Address - Street 2:
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-1591
Practice Address - Country:US
Practice Address - Phone:808-633-7132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-29
Last Update Date:2023-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-4069-02084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry