Provider Demographics
NPI:1265212898
Name:MILLER, HEATHER ELAINE (LBD)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ELAINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:LBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29780 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SHEDD
Mailing Address - State:OR
Mailing Address - Zip Code:97377-9713
Mailing Address - Country:US
Mailing Address - Phone:541-639-9994
Mailing Address - Fax:
Practice Address - Street 1:29780 MAIN ST
Practice Address - Street 2:
Practice Address - City:SHEDD
Practice Address - State:OR
Practice Address - Zip Code:97377-9713
Practice Address - Country:US
Practice Address - Phone:541-639-9994
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORTHW000109732374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula