Provider Demographics
NPI:1760930259
Name:MILLER, AMY
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:AMY
Other - Middle Name:MILLER
Other - Last Name:UDDO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RNFA,CNOR
Mailing Address - Street 1:38 TOKALON PL
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70001-3020
Mailing Address - Country:US
Mailing Address - Phone:504-914-4453
Mailing Address - Fax:
Practice Address - Street 1:38 TOKALON PL
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70001-3020
Practice Address - Country:US
Practice Address - Phone:504-914-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-14
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN111112163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant