Provider Demographics
NPI:1477114999
Name:MILLER, ASHLEY NILE
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NILE
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 1:16327 130TH AVE APT 4G
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3039
Mailing Address - Country:US
Mailing Address - Phone:917-304-8144
Mailing Address - Fax:
Practice Address - Street 1:16327 130TH AVE APT 4G
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3039
Practice Address - Country:US
Practice Address - Phone:917-304-8144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2019-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist