Provider Demographics
NPI:1114606233
Name:MCMILLER, CHRISTI EVON (HOME HEALTH AIDE)
Entity Type:Individual
Prefix:
First Name:CHRISTI
Middle Name:EVON
Last Name:MCMILLER
Suffix:
Gender:F
Credentials:HOME HEALTH AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2220 LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48206-1568
Mailing Address - Country:US
Mailing Address - Phone:313-457-5112
Mailing Address - Fax:
Practice Address - Street 1:2220 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48206-1568
Practice Address - Country:US
Practice Address - Phone:313-457-5112
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide