Provider Demographics
NPI:1356985204
Name:MILLER, SHARON LOUISE
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:LOUISE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 339
Mailing Address - Street 2:
Mailing Address - City:AUBERRY
Mailing Address - State:CA
Mailing Address - Zip Code:93602-0339
Mailing Address - Country:US
Mailing Address - Phone:559-855-5264
Mailing Address - Fax:559-855-5264
Practice Address - Street 1:34475 POWERHOUSE RD
Practice Address - Street 2:
Practice Address - City:AUBERRY
Practice Address - State:CA
Practice Address - Zip Code:93602-9654
Practice Address - Country:US
Practice Address - Phone:559-765-5028
Practice Address - Fax:559-855-5264
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN232731164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse