Provider Demographics
NPI:1982015566
Name:MILLER, DOUGLAS (RRT, RN)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:RRT, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10003
Mailing Address - Street 2:PMB 64
Mailing Address - City:SAIPAN
Mailing Address - State:MP
Mailing Address - Zip Code:96950-8903
Mailing Address - Country:US
Mailing Address - Phone:670-483-2441
Mailing Address - Fax:
Practice Address - Street 1:1 NAVY HILL
Practice Address - Street 2:
Practice Address - City:SAIPAN
Practice Address - State:MP
Practice Address - Zip Code:96950
Practice Address - Country:US
Practice Address - Phone:670-234-8950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MPR99561163W00000X
WI568-282279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care
No163W00000XNursing Service ProvidersRegistered Nurse