Provider Demographics
NPI:1003853854
Name:MILLER, JULIANA (NP)
Entity Type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 S MAIN ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08055-2431
Mailing Address - Country:US
Mailing Address - Phone:609-536-9890
Mailing Address - Fax:
Practice Address - Street 1:60 SOUTH MAIN STREET
Practice Address - Street 2:UNIT A
Practice Address - City:MEDFORD
Practice Address - State:NJ
Practice Address - Zip Code:08055-2371
Practice Address - Country:US
Practice Address - Phone:609-536-9890
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00099700363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health