Provider Demographics
NPI:1619250214
Name:MILLER, BRITTANY (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39169 WATER OAK AVE
Mailing Address - Street 2:
Mailing Address - City:PRAIRIEVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70769-4620
Mailing Address - Country:US
Mailing Address - Phone:504-330-3846
Mailing Address - Fax:
Practice Address - Street 1:2221 PHILIP ST STE Q
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70113-2525
Practice Address - Country:US
Practice Address - Phone:504-571-9120
Practice Address - Fax:504-524-5545
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12701183500000X
LA018965183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA0866167Medicaid
LA0866167Medicaid
LA0866167Medicare PIN
LA0866167Medicare UPIN