Provider Demographics
NPI:1003035247
Name:MILLER, KAREN KELLY
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:KELLY
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 1:6950 CASTLEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-3915
Mailing Address - Country:US
Mailing Address - Phone:937-829-5698
Mailing Address - Fax:
Practice Address - Street 1:6950 CASTLEBROOK DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-3915
Practice Address - Country:US
Practice Address - Phone:937-829-5698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide