Provider Demographics
NPI:1396017430
Name:MILLER, TERESEA N (HEARING AIDS)
Entity Type:Individual
Prefix:MRS
First Name:TERESEA
Middle Name:N
Last Name:MILLER
Suffix:
Gender:F
Credentials:HEARING AIDS
Other - Prefix:MRS
Other - First Name:TERESEA
Other - Middle Name:N
Other - Last Name:HATLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:HEARING AIDS
Mailing Address - Street 1:3716 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-8915
Mailing Address - Country:US
Mailing Address - Phone:270-584-5572
Mailing Address - Fax:
Practice Address - Street 1:1871 US HIGHWAY 41A S
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:KY
Practice Address - Zip Code:42409-9448
Practice Address - Country:US
Practice Address - Phone:270-584-5572
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-06
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0464237700000X
KY101418237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument SpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1396017430OtherAMERICAN HEARING BENEFITS