Provider Demographics
NPI:1942718341
Name:MILLER, PAIGE (DNP, CNM, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:DNP, CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1093 E CEDAR RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84094-5655
Mailing Address - Country:US
Mailing Address - Phone:801-231-2327
Mailing Address - Fax:
Practice Address - Street 1:654 S 900 E
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-3478
Practice Address - Country:US
Practice Address - Phone:801-322-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-19
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8729499-4402176B00000X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife