Provider Demographics
NPI:1659467611
Name:MILLER, ANA M (RN, CWOCN)
Entity Type:Individual
Prefix:MR
First Name:ANA
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, CWOCN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40294 PINEWOOD CT
Mailing Address - Street 2:
Mailing Address - City:BROWERVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:56438-4598
Mailing Address - Country:US
Mailing Address - Phone:218-821-5488
Mailing Address - Fax:309-782-1368
Practice Address - Street 1:1 ROCK ISLAND ARSENAL
Practice Address - Street 2:
Practice Address - City:ROCK ISLAND
Practice Address - State:IL
Practice Address - Zip Code:61299-7530
Practice Address - Country:US
Practice Address - Phone:309-782-6950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 121 849 3163WW0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WW0000XNursing Service ProvidersRegistered NurseWound Care