Provider Demographics
NPI:1669484408
Name:MILLER, ERIC (RN)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 827
Mailing Address - Street 2:BOX 12
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09617
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PSC 827
Practice Address - Street 2:BOX 12
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09617
Practice Address - Country:US
Practice Address - Phone:629-6472
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRN40236163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology