Provider Demographics
NPI:1861012387
Name:MILLER, ERICA JOY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERICA
Middle Name:JOY
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:ERICA
Other - Middle Name:JOY
Other - Last Name:GARDNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 635
Mailing Address - Street 2:
Mailing Address - City:LATIMER
Mailing Address - State:IA
Mailing Address - Zip Code:50452-0635
Mailing Address - Country:US
Mailing Address - Phone:641-512-5223
Mailing Address - Fax:
Practice Address - Street 1:1720 CENTRAL AVE E
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:IA
Practice Address - Zip Code:50441-1869
Practice Address - Country:US
Practice Address - Phone:641-456-5000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-24
Last Update Date:2021-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19560183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist