Provider Demographics
NPI:1558598227
Name:MILLER, DEANNA RAE (RCP,CPT 2, MA, CNA)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:RAE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RCP,CPT 2, MA, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6712 CITO RD
Mailing Address - Street 2:
Mailing Address - City:MC CONNELLSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17233-8716
Mailing Address - Country:US
Mailing Address - Phone:631-764-5432
Mailing Address - Fax:267-935-7602
Practice Address - Street 1:6712 CITO RD
Practice Address - Street 2:
Practice Address - City:MC CONNELLSBURG
Practice Address - State:PA
Practice Address - Zip Code:17233-8716
Practice Address - Country:US
Practice Address - Phone:631-764-5432
Practice Address - Fax:267-935-7602
Is Sole Proprietor?:No
Enumeration Date:2009-06-19
Last Update Date:2013-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171000000X
CA33779227800000X
CA657984376K00000X
CACPA3850246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified
No171000000XOther Service ProvidersMilitary Health Care Provider
No376K00000XNursing Service Related ProvidersNurse's Aide
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy