Provider Demographics
NPI:1578131934
Name:MILLAR, NINA A (RN, CPM, LM)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:A
Last Name:MILLAR
Suffix:
Gender:F
Credentials:RN, CPM, LM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1132
Mailing Address - Street 2:
Mailing Address - City:HONOKAA
Mailing Address - State:HI
Mailing Address - Zip Code:96727-1132
Mailing Address - Country:US
Mailing Address - Phone:808-938-6072
Mailing Address - Fax:888-977-3122
Practice Address - Street 1:44-3643 KUKUIPAPA RD
Practice Address - Street 2:
Practice Address - City:HONOKAA
Practice Address - State:HI
Practice Address - Zip Code:96727
Practice Address - Country:US
Practice Address - Phone:808-938-6072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-14
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMW-10176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife