Provider Demographics
NPI:1295564524
Name:MILLER, ANDREW HAYDEN (CRNA, DNP)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:HAYDEN
Last Name:MILLER
Suffix:
Gender:M
Credentials:CRNA, DNP
Other - Prefix:DR
Other - First Name:ANDREW
Other - Middle Name:HAYDEN
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CRNA, DNP
Mailing Address - Street 1:1885 W 52ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44102-3339
Mailing Address - Country:US
Mailing Address - Phone:352-598-1239
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0001
Practice Address - Country:US
Practice Address - Phone:352-598-1239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-26
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.500478163W00000X
WAAP61659445207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care MedicineGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered Nurse