Provider Demographics
NPI:1346908399
Name:MILLER, EERAIS (FNP-BC, NP-C)
Entity Type:Individual
Prefix:MRS
First Name:EERAIS
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP-BC, NP-C
Other - Prefix:MRS
Other - First Name:EERAIS
Other - Middle Name:
Other - Last Name:STARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3024 N LINDA VISTA CT
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93291-3921
Mailing Address - Country:US
Mailing Address - Phone:559-798-7575
Mailing Address - Fax:
Practice Address - Street 1:1633 S COURT ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93277-4945
Practice Address - Country:US
Practice Address - Phone:559-624-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95019339363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty