Provider Demographics
NPI:1073512117
Name:MILLER, DONNA (MD)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8906 SPANISH RIDGE AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1304
Mailing Address - Country:US
Mailing Address - Phone:702-330-3102
Mailing Address - Fax:702-912-4994
Practice Address - Street 1:861 CORONADO CENTER DR
Practice Address - Street 2:SUITE 131
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-3992
Practice Address - Country:US
Practice Address - Phone:725-777-0414
Practice Address - Fax:702-565-5027
Is Sole Proprietor?:No
Enumeration Date:2005-07-20
Last Update Date:2017-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NV9682207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV002018801Medicaid
NVV108124Medicare UPIN
NV002018801Medicaid