Provider Demographics
NPI:1821379199
Name:MILLER, SARAH M (LVN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:M
Last Name:MILLER
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3923 MESA DR APT 202
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-2623
Mailing Address - Country:US
Mailing Address - Phone:760-936-6328
Mailing Address - Fax:
Practice Address - Street 1:3923 MESA DR APT 202
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-2623
Practice Address - Country:US
Practice Address - Phone:760-936-6328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-31
Last Update Date:2011-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA259800164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse