Provider Demographics
NPI:1134838055
Name:MILLER, ZACHARIAS
Entity type:Individual
Prefix:
First Name:ZACHARIAS
Middle Name:
Last Name:MILLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 DEER VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:CO
Mailing Address - Zip Code:81647-8526
Mailing Address - Country:US
Mailing Address - Phone:707-362-0625
Mailing Address - Fax:
Practice Address - Street 1:132 DEER VALLEY DR
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:CO
Practice Address - Zip Code:81647-8526
Practice Address - Country:US
Practice Address - Phone:707-362-0625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA753104163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse