Provider Demographics
NPI:1386523165
Name:MILLER, PEARL TRYPHENA
Entity type:Individual
Prefix:
First Name:PEARL
Middle Name:TRYPHENA
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 1:1910 N 81ST ST APT 4
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-1575
Mailing Address - Country:US
Mailing Address - Phone:402-968-1221
Mailing Address - Fax:
Practice Address - Street 1:1910 N 81ST ST APT 4
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-1575
Practice Address - Country:US
Practice Address - Phone:402-968-1221
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-27
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant