Provider Demographics
NPI:1295044360
Name:MILLER, CANDI MARIE (STNA)
Entity Type:Individual
Prefix:MRS
First Name:CANDI
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1892 QUAYLE DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-2136
Mailing Address - Country:US
Mailing Address - Phone:330-534-2427
Mailing Address - Fax:
Practice Address - Street 1:1892 QUAYLE DR
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-2136
Practice Address - Country:US
Practice Address - Phone:330-534-2427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-06
Last Update Date:2010-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide