Provider Demographics
NPI:1609954338
Name:MILLER, JULIA Z (NURSE PRACTIONER)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:Z
Last Name:MILLER
Suffix:
Gender:F
Credentials:NURSE PRACTIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 MAPLE WALK
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSON
Mailing Address - State:WV
Mailing Address - Zip Code:25661-3307
Mailing Address - Country:US
Mailing Address - Phone:304-235-3791
Mailing Address - Fax:304-369-2832
Practice Address - Street 1:213 KENMORE DRIVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25053
Practice Address - Country:US
Practice Address - Phone:304-369-7967
Practice Address - Fax:304-369-2832
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV29590363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVQ54593Medicare UPIN
WVBFOV91121Medicare ID - Type Unspecified