Provider Demographics
NPI:1376238717
Name:MILLER, ALAINA ABDELAZIZ (FNP-C)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:ABDELAZIZ
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ALAINA
Other - Middle Name:THERESA
Other - Last Name:ABDELAZIZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:665 S CHAMBERLAIN ST
Mailing Address - Street 2:
Mailing Address - City:MAPLETON
Mailing Address - State:UT
Mailing Address - Zip Code:84664-4456
Mailing Address - Country:US
Mailing Address - Phone:310-619-4986
Mailing Address - Fax:
Practice Address - Street 1:665 S CHAMBERLAIN ST
Practice Address - Street 2:
Practice Address - City:MAPLETON
Practice Address - State:UT
Practice Address - Zip Code:84664-4456
Practice Address - Country:US
Practice Address - Phone:310-619-4986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-11
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ290089363LF0000X
UT13355329-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty