Provider Demographics
NPI:1245743046
Name:MILLER, CYNTHIA A (RN)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:A
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:PO BOX 841432
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0077
Mailing Address - Country:US
Mailing Address - Phone:361-443-7932
Mailing Address - Fax:713-340-2834
Practice Address - Street 1:13615 SILENT WALK DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3740
Practice Address - Country:US
Practice Address - Phone:713-340-2834
Practice Address - Fax:713-340-2834
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-15
Last Update Date:2017-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX649224171M00000X, 174H00000X, 405300000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator
No405300000XOther Service ProvidersPrevention Professional