Provider Demographics
NPI:1023639853
Name:MILLER, OLIVIA PRICE
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:PRICE
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 1:705 NTH 8TH AVE
Mailing Address - Street 2:3B
Mailing Address - City:DILLON
Mailing Address - State:SC
Mailing Address - Zip Code:29536-2600
Mailing Address - Country:US
Mailing Address - Phone:843-449-0453
Mailing Address - Fax:
Practice Address - Street 1:705 NTH 8TH AVE
Practice Address - Street 2:3B
Practice Address - City:DILLON
Practice Address - State:SC
Practice Address - Zip Code:29536
Practice Address - Country:US
Practice Address - Phone:843-449-0453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-04
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC24583363LF0000X, 207N00000X, 363L00000X
SC234927163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse