Provider Demographics
NPI:1437881786
Name:MILLER, REBECCA (RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 PEARL BROOK RD
Mailing Address - Street 2:
Mailing Address - City:WEST TOWNSEND
Mailing Address - State:MA
Mailing Address - Zip Code:01474-1107
Mailing Address - Country:US
Mailing Address - Phone:978-985-3301
Mailing Address - Fax:
Practice Address - Street 1:3 PEARL BROOK RD
Practice Address - Street 2:
Practice Address - City:WEST TOWNSEND
Practice Address - State:MA
Practice Address - Zip Code:01474-1107
Practice Address - Country:US
Practice Address - Phone:978-985-3301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2270216163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management