Provider Demographics
NPI:1922519651
Name:MILLER, VERONICA ANN PABLO (NP)
Entity Type:Individual
Prefix:
First Name:VERONICA ANN
Middle Name:PABLO
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31521 SIX RIVERS CT
Mailing Address - Street 2:
Mailing Address - City:TEMECULA
Mailing Address - State:CA
Mailing Address - Zip Code:92592-2889
Mailing Address - Country:US
Mailing Address - Phone:760-583-4313
Mailing Address - Fax:
Practice Address - Street 1:8990 GARFIELD ST STE 8
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3922
Practice Address - Country:US
Practice Address - Phone:714-944-0948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-20
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95007575363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner