Provider Demographics
NPI:1932315413
Name:MILLER, ADRIAN JEAN (RN,MSN,APN,CNS,CWOCN)
Entity Type:Individual
Prefix:MR
First Name:ADRIAN
Middle Name:JEAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:RN,MSN,APN,CNS,CWOCN
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:116 WESTROCK FARM DR
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:OH
Mailing Address - Zip Code:45322-2944
Mailing Address - Country:US
Mailing Address - Phone:937-836-5019
Mailing Address - Fax:937-836-5019
Practice Address - Street 1:1 WYOMING ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-3780
Practice Address - Fax:937-208-2883
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHRN155780364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHMM0933398OtherDEA