Provider Demographics
NPI:1992705941
Name:MILLER, BARBARA R (FNP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:R
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2617 SHEFFIELD DR
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24060-8271
Mailing Address - Country:US
Mailing Address - Phone:540-953-2210
Mailing Address - Fax:540-951-9112
Practice Address - Street 1:2617 SHEFFIELD DR
Practice Address - Street 2:NEW RIVER DERMATOLOGY
Practice Address - City:BLACKSBURG
Practice Address - State:VA
Practice Address - Zip Code:24060-8271
Practice Address - Country:US
Practice Address - Phone:540-953-2210
Practice Address - Fax:540-951-9112
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017137391363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA5901928Medicaid
VAH02745Medicare UPIN
VA5901928Medicaid