Provider Demographics
NPI:1134547565
Name:MILLER, KAREN (RPH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
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 1:11 N MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:GRANT
Mailing Address - State:MI
Mailing Address - Zip Code:49327-7900
Mailing Address - Country:US
Mailing Address - Phone:231-834-1567
Mailing Address - Fax:231-834-1567
Practice Address - Street 1:11 N MAPLE ST
Practice Address - Street 2:
Practice Address - City:GRANT
Practice Address - State:MI
Practice Address - Zip Code:49327-7900
Practice Address - Country:US
Practice Address - Phone:231-834-1567
Practice Address - Fax:231-834-1568
Is Sole Proprietor?:No
Enumeration Date:2014-04-02
Last Update Date:2014-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302035374183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist