Provider Demographics
NPI:1508864067
Name:MILLER, JOSEPH JOHN (NP)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:JOHN
Last Name:MILLER
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 ROCHESTER HILL RD
Mailing Address - Street 2:UNIT 2
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-1775
Mailing Address - Country:US
Mailing Address - Phone:603-332-0238
Mailing Address - Fax:603-332-7098
Practice Address - Street 1:245 ROCHESTER HILL RD
Practice Address - Street 2:UNIT 2
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1775
Practice Address - Country:US
Practice Address - Phone:603-332-0238
Practice Address - Fax:603-332-7098
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA228830363LP0200X
NH046201-23363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP1986OtherBLUE CROSS BLUE SHIELD
MAS88708Medicare UPIN
MANP1986Medicare ID - Type Unspecified