Provider Demographics
NPI:1053837849
Name:MILLER, HALEY MARIE
Entity Type:Individual
Prefix:MS
First Name:HALEY
Middle Name:MARIE
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 1:4325 W COUNTY ROAD 400 N
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47634-9514
Mailing Address - Country:US
Mailing Address - Phone:812-393-0880
Mailing Address - Fax:
Practice Address - Street 1:4325 W COUNTY ROAD 400 N
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:IN
Practice Address - Zip Code:47634
Practice Address - Country:US
Practice Address - Phone:812-393-0880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program