Provider Demographics
NPI:1437900172
Name:MILLER, ANNIE M
Entity Type:Individual
Prefix:MRS
First Name:ANNIE
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:
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 8732
Mailing Address - Street 2:
Mailing Address - City:BENTON HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:49023-8732
Mailing Address - Country:US
Mailing Address - Phone:269-308-2389
Mailing Address - Fax:
Practice Address - Street 1:1186 CIRCLE DR BLDG J
Practice Address - Street 2:
Practice Address - City:BENTON HARBOR
Practice Address - State:MI
Practice Address - Zip Code:49022-2202
Practice Address - Country:US
Practice Address - Phone:269-308-2389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide