Provider Demographics
NPI:1265018386
Name:MILLER, RHAQUESE ASHANTI (RN)
Entity Type:Individual
Prefix:
First Name:RHAQUESE
Middle Name:ASHANTI
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 1:5661 LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:FL
Mailing Address - Zip Code:32344-5425
Mailing Address - Country:US
Mailing Address - Phone:850-242-1689
Mailing Address - Fax:
Practice Address - Street 1:5661 LAKE RD
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:FL
Practice Address - Zip Code:32344-5425
Practice Address - Country:US
Practice Address - Phone:850-242-1689
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-19
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPN096798164W00000X
FLRN9584810163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health
No164W00000XNursing Service ProvidersLicensed Practical Nurse