Provider Demographics
NPI:1093327207
Name:MILLER, SYNTHIA NICOLE
Entity Type:Individual
Prefix:
First Name:SYNTHIA
Middle Name:NICOLE
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 1:118 136TH ST
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:WV
Mailing Address - Zip Code:25315-1508
Mailing Address - Country:US
Mailing Address - Phone:304-949-2783
Mailing Address - Fax:
Practice Address - Street 1:118 136TH ST
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:WV
Practice Address - Zip Code:25315-1508
Practice Address - Country:US
Practice Address - Phone:304-949-2783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant