Provider Demographics
NPI:1003363839
Name:MILLER, STEPHANIE E (CRNP)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:E
Last Name:MILLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 PENN AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3208
Mailing Address - Country:US
Mailing Address - Phone:412-442-2343
Mailing Address - Fax:412-325-2536
Practice Address - Street 1:501 PENN AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3208
Practice Address - Country:US
Practice Address - Phone:412-442-2343
Practice Address - Fax:412-325-2536
Is Sole Proprietor?:No
Enumeration Date:2016-09-09
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016368363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA103193502Medicaid
13898800OtherCAQH