Provider Demographics
NPI:1184679771
Name:MILLER, TOMMIE LOUISE (RN)
Entity Type:Individual
Prefix:MS
First Name:TOMMIE
Middle Name:LOUISE
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 1:2112 CHRISTOPHER DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-2004
Mailing Address - Country:US
Mailing Address - Phone:757-393-8585
Mailing Address - Fax:757-393-8027
Practice Address - Street 1:1701 HIGH ST
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23704-3103
Practice Address - Country:US
Practice Address - Phone:757-393-8585
Practice Address - Fax:757-393-8027
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001110915163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management