Provider Demographics
NPI:1710932058
Name:MILLER, MAURA FARRELL (PHD, ARNP, BC)
Entity Type:Individual
Prefix:DR
First Name:MAURA
Middle Name:FARRELL
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHD, ARNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6526 WINDING LAKE DR
Mailing Address - Street 2:
Mailing Address - City:JUPITER
Mailing Address - State:FL
Mailing Address - Zip Code:33458-3788
Mailing Address - Country:US
Mailing Address - Phone:561-744-5133
Mailing Address - Fax:561-744-1634
Practice Address - Street 1:WEST PALM BEACH VAMC 548/118-EC
Practice Address - Street 2:7305 NORTH MILITARY TRAIL
Practice Address - City:RIVIERA BEACH
Practice Address - State:FL
Practice Address - Zip Code:33410-7417
Practice Address - Country:US
Practice Address - Phone:561-422-8262
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP: 1084522363LG0600X
FLARNP1084522363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Not Answered363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health