Provider Demographics
NPI:1982646147
Name:MILLER, ELIZABETH JOANNA (RPH)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JOANNA
Last Name:MILLER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:891 SPRINGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:N SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84054-3041
Mailing Address - Country:US
Mailing Address - Phone:801-585-0172
Mailing Address - Fax:801-585-2988
Practice Address - Street 1:1950 CIRCLE OF HOPE DR
Practice Address - Street 2:STE 2110
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112-5500
Practice Address - Country:US
Practice Address - Phone:801-585-0172
Practice Address - Fax:801-585-2988
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1509181701183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist