Provider Demographics
NPI:1578243093
Name:MILLER, TONYA (MPH, MCHC)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MPH, MCHC
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:
Other - Last Name:DIBIASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH
Mailing Address - Street 1:8500 N ATLAS RD
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-8332
Mailing Address - Country:US
Mailing Address - Phone:208-415-5231
Mailing Address - Fax:
Practice Address - Street 1:8500 N ATLAS RD
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-8332
Practice Address - Country:US
Practice Address - Phone:208-415-5231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator