Provider Demographics
NPI:1558305607
Name:MILLER, HEATHER ANNE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:ANNE
Last Name:MILLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:ANNE
Other - Last Name:WITHROW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 1430
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22803-1430
Mailing Address - Country:US
Mailing Address - Phone:540-564-5500
Mailing Address - Fax:540-564-5444
Practice Address - Street 1:640 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22801-5819
Practice Address - Country:US
Practice Address - Phone:540-564-5500
Practice Address - Fax:540-564-5444
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-107066363LA2200X
VA0024174020363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1558305607Medicaid