Provider Demographics
NPI:1922217868
Name:MILLER, DEBRA ANN (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5028 MONTEGO DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31909-3423
Mailing Address - Country:US
Mailing Address - Phone:706-536-1768
Mailing Address - Fax:
Practice Address - Street 1:5028 MONTEGO DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31909-3423
Practice Address - Country:US
Practice Address - Phone:706-536-1768
Practice Address - Fax:706-221-6870
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2015-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN058426163WL0100X
AL1-072309163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant