Provider Demographics
NPI:1083731582
Name:MILLER, DEBORAH E (APRN)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:E
Last Name:MILLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7648 CAMMINARE DR
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34238-4774
Mailing Address - Country:US
Mailing Address - Phone:203-451-0838
Mailing Address - Fax:800-905-4566
Practice Address - Street 1:7648 CAMMINARE DR
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34238-4774
Practice Address - Country:US
Practice Address - Phone:203-451-0838
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2019-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9375336364SP0813X
CT002591363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Geropsychiatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT31544OtherCONRTOLLED SUBSTANCE
CTMS0768551OtherDEA