Provider Demographics
NPI:1013489137
Name:MILLER, KEENA ROCHELLE
Entity Type:Individual
Prefix:MISS
First Name:KEENA
Middle Name:ROCHELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1474 THOMASTON DR APT C
Mailing Address - Street 2:
Mailing Address - City:AMELIA
Mailing Address - State:OH
Mailing Address - Zip Code:45102-1071
Mailing Address - Country:US
Mailing Address - Phone:513-462-8985
Mailing Address - Fax:
Practice Address - Street 1:4706 BEECHWOOD RD APT 206E
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-1842
Practice Address - Country:US
Practice Address - Phone:513-688-7557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-31
Last Update Date:2018-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide