Provider Demographics
NPI:1417944844
Name:MILLER, LINDA MARGUERITA (RN CRNP)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:MARGUERITA
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN CRNP
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:MARGUREITA
Other - Last Name:MILLERCALANDRA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8821 PATTON RD
Mailing Address - Street 2:
Mailing Address - City:WYNDMOOR
Mailing Address - State:PA
Mailing Address - Zip Code:19038-7433
Mailing Address - Country:US
Mailing Address - Phone:215-836-2494
Mailing Address - Fax:
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:ENT DEPT FIRST FLOOR WOOD BLDG
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4306
Practice Address - Country:US
Practice Address - Phone:215-590-3440
Practice Address - Fax:215-590-3986
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN231754L363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics