Provider Demographics
NPI:1235670845
Name:MILLER, MARCI
Entity Type:Individual
Prefix:
First Name:MARCI
Middle Name:
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 1:106 E 3RD ST
Mailing Address - Street 2:#3B
Mailing Address - City:MOSCOW
Mailing Address - State:ID
Mailing Address - Zip Code:83843-2970
Mailing Address - Country:US
Mailing Address - Phone:208-503-6320
Mailing Address - Fax:
Practice Address - Street 1:106 E 3RD ST
Practice Address - Street 2:#3B
Practice Address - City:MOSCOW
Practice Address - State:ID
Practice Address - Zip Code:83843-2970
Practice Address - Country:US
Practice Address - Phone:208-503-6320
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula