Provider Demographics
NPI:1700188455
Name:MILLER, MARJORIE ANN (RN)
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 PEPPER DR APT D
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-3336
Mailing Address - Country:US
Mailing Address - Phone:559-800-7500
Mailing Address - Fax:
Practice Address - Street 1:529 PEPPER DR APT D
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-3336
Practice Address - Country:US
Practice Address - Phone:559-800-7500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530743163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health