Provider Demographics
NPI:1164605978
Name:MILLER, LORI L (RN, CNOR, RNFA)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 WOODGLEN DR
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2220
Mailing Address - Country:US
Mailing Address - Phone:512-507-9210
Mailing Address - Fax:512-255-5541
Practice Address - Street 1:1913 WOODGLEN DR
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-2220
Practice Address - Country:US
Practice Address - Phone:512-507-9210
Practice Address - Fax:512-255-5541
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-14
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX532918163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX04QEOtherBCBS PROVIDER NUMBER