Provider Demographics
NPI:1598898496
Name:MILLER, SUSAN SWEENEY (CNM RN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:SWEENEY
Last Name:MILLER
Suffix:
Gender:F
Credentials:CNM RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2080 WHITNEY AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518
Mailing Address - Country:US
Mailing Address - Phone:203-248-4461
Mailing Address - Fax:203-288-6761
Practice Address - Street 1:2514 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:GUILFORD
Practice Address - State:CT
Practice Address - Zip Code:06437
Practice Address - Country:US
Practice Address - Phone:203-453-4766
Practice Address - Fax:203-453-6402
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTQ00116176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
M191089OtherCACQH
M191089OtherCACQH