Provider Demographics
NPI:1417127556
Name:MILLER, VERONICA (RN, CRNA)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 632572
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-2572
Mailing Address - Country:US
Mailing Address - Phone:513-865-5204
Mailing Address - Fax:
Practice Address - Street 1:1241 SHAWHAN RD
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-9695
Practice Address - Country:US
Practice Address - Phone:513-865-5204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH250302367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH079125OtherRECERT
OH250302OtherOHIO LICENSE