Provider Demographics
NPI:1689965725
Name:MILLER, HEATHER STARR (RN,BSN,IBCLC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:STARR
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN,BSN,IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5904 SIX FORKS RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-3838
Mailing Address - Country:US
Mailing Address - Phone:919-787-9555
Mailing Address - Fax:919-510-5111
Practice Address - Street 1:5904 SIX FORKS RD
Practice Address - Street 2:SUITE 111
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-3838
Practice Address - Country:US
Practice Address - Phone:919-787-9555
Practice Address - Fax:919-510-5111
Is Sole Proprietor?:No
Enumeration Date:2011-04-24
Last Update Date:2016-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC172308163W00000X
NC10912431163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
No163W00000XNursing Service ProvidersRegistered Nurse