Provider Demographics
NPI:1437868387
Name:MILLER, NKENGE (DOULA)
Entity Type:Individual
Prefix:
First Name:NKENGE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 N CLAY AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63135-3506
Mailing Address - Country:US
Mailing Address - Phone:314-642-1905
Mailing Address - Fax:
Practice Address - Street 1:420 N CLAY AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63135-3506
Practice Address - Country:US
Practice Address - Phone:314-642-1905
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula