Provider Demographics
NPI:1760087928
Name:MILLER, JANEEKA SHARPE (MED, ATC)
Entity Type:Individual
Prefix:
First Name:JANEEKA
Middle Name:SHARPE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MED, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W RAMSEUR DR
Mailing Address - Street 2:
Mailing Address - City:BLACKSBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29702-1824
Mailing Address - Country:US
Mailing Address - Phone:864-206-2378
Mailing Address - Fax:
Practice Address - Street 1:201 W RAMSEUR DR
Practice Address - Street 2:
Practice Address - City:BLACKSBURG
Practice Address - State:SC
Practice Address - Zip Code:29702-1824
Practice Address - Country:US
Practice Address - Phone:864-206-2378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-03
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20000061222255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer