Provider Demographics
NPI:1598022378
Name:MILLER, SCOTT (CRNA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1094 E 200 S
Mailing Address - Street 2:
Mailing Address - City:SPRINGVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84663-2712
Mailing Address - Country:US
Mailing Address - Phone:801-310-8458
Mailing Address - Fax:
Practice Address - Street 1:300 N HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PRICE
Practice Address - State:UT
Practice Address - Zip Code:84501-4218
Practice Address - Country:US
Practice Address - Phone:801-310-8458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX815882367500000X
UT5700298-4406367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered