Provider Demographics
NPI:1558976621
Name:MILLER, RUBY KAY (LPN)
Entity Type:Individual
Prefix:MS
First Name:RUBY
Middle Name:KAY
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 TOWER CT
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-1540
Mailing Address - Country:US
Mailing Address - Phone:740-500-9738
Mailing Address - Fax:
Practice Address - Street 1:1387 GEORGESVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228-3611
Practice Address - Country:US
Practice Address - Phone:614-859-0400
Practice Address - Fax:614-351-5250
Is Sole Proprietor?:No
Enumeration Date:2020-09-15
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.160861.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHLPN.160861.MEDS-IVOtherOHIO LPN LICENSE