Provider Demographics
NPI:1003408055
Name:MILLER, ABRIE
Entity Type:Individual
Prefix:
First Name:ABRIE
Middle Name:
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 1:1490 BLUE JAY SIX RD
Mailing Address - Street 2:
Mailing Address - City:COAL CITY
Mailing Address - State:WV
Mailing Address - Zip Code:25823
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1490 BLUE JAY SIX RD
Practice Address - Street 2:
Practice Address - City:COAL CITY
Practice Address - State:WV
Practice Address - Zip Code:25823
Practice Address - Country:US
Practice Address - Phone:304-890-6177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider