Provider Demographics
NPI:1295047652
Name:MILLER, JULIANNE (RN, BSN, CST, DOCTOR)
Entity type:Individual
Prefix:
First Name:JULIANNE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, BSN, CST, DOCTOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25411 CABOT ROAD
Mailing Address - Street 2:SUITE 209
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-273-6240
Mailing Address - Fax:949-273-6241
Practice Address - Street 1:25411 CABOT ROAD
Practice Address - Street 2:SUITE 207
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-273-6240
Practice Address - Fax:949-273-6241
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-13
Last Update Date:2010-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN,306709163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse