Provider Demographics
NPI:1417466426
Name:MILLER, SHONDRIA NICOLE (RN)
Entity Type:Individual
Prefix:MISS
First Name:SHONDRIA
Middle Name:NICOLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1918 MECHANICSBURG RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-3147
Mailing Address - Country:US
Mailing Address - Phone:937-398-0274
Mailing Address - Fax:937-399-3112
Practice Address - Street 1:1918 MECHANICSBURG ROAD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:43044
Practice Address - Country:US
Practice Address - Phone:937-398-0274
Practice Address - Fax:937-399-3112
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.164878.MED-IV164W00000X
OHRN.457456163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164W00000XNursing Service ProvidersLicensed Practical Nurse