Provider Demographics
NPI:1578546016
Name:MILLER, SARAH L (ACNP)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:L
Last Name:MILLER
Suffix:
Gender:F
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 WHITE OAK DR
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9271
Mailing Address - Country:US
Mailing Address - Phone:614-905-2792
Mailing Address - Fax:
Practice Address - Street 1:1790 WHITE OAK DR
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-9271
Practice Address - Country:US
Practice Address - Phone:614-905-2792
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2013-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP16471363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CARN603660Medicaid
CARN603660Medicaid