Provider Demographics
NPI:1073557161
Name:MILLER, DANA KATHLEEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:KATHLEEN
Last Name:MILLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3525 LOCHWOOD DR NE
Mailing Address - Street 2:
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52402-3372
Mailing Address - Country:US
Mailing Address - Phone:319-364-7609
Mailing Address - Fax:319-363-3041
Practice Address - Street 1:3525 LOCHWOOD DR NE
Practice Address - Street 2:
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52402-3372
Practice Address - Country:US
Practice Address - Phone:319-364-7609
Practice Address - Fax:319-363-3041
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA15949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist