Provider Demographics
NPI:1164158986
Name:MILLER, KELLI NIRA (RN)
Entity Type:Individual
Prefix:
First Name:KELLI
Middle Name:NIRA
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10303 RIVERBURN DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33647-3164
Mailing Address - Country:US
Mailing Address - Phone:813-952-8701
Mailing Address - Fax:
Practice Address - Street 1:10303 RIVERBURN DR
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33647-3164
Practice Address - Country:US
Practice Address - Phone:813-952-8701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care