Provider Demographics
NPI:1598041386
Name:MILLER, RUTH ANN (LPN)
Entity Type:Individual
Prefix:
First Name:RUTH
Middle Name:ANN
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 1:3024 GLENWOOD PARK AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16508-2712
Mailing Address - Country:US
Mailing Address - Phone:814-453-4096
Mailing Address - Fax:
Practice Address - Street 1:3024 GLENWOOD PARK AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16508-2712
Practice Address - Country:US
Practice Address - Phone:814-453-4096
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-25
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN084428L164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse