Provider Demographics
NPI:1558951020
Name:MILLER, DEE ANN (RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:DEE
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 PERCEPTION CIR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32570-8165
Mailing Address - Country:US
Mailing Address - Phone:334-477-6857
Mailing Address - Fax:
Practice Address - Street 1:4575 PERCEPTION CIR
Practice Address - Street 2:
Practice Address - City:MILTON
Practice Address - State:FL
Practice Address - Zip Code:32570-8165
Practice Address - Country:US
Practice Address - Phone:334-477-6857
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-19
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9548427163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant