Provider Demographics
NPI:1356198303
Name:MILLER, SHELBY NICHOLE (BSN, RN)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:NICHOLE
Last Name:MILLER
Suffix:
Gender:X
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2935 MILL ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3711
Mailing Address - Country:US
Mailing Address - Phone:615-489-3557
Mailing Address - Fax:
Practice Address - Street 1:2935 MILL ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3711
Practice Address - Country:US
Practice Address - Phone:615-489-3557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201906230163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse