Provider Demographics
NPI:1396795308
Name:MILLER, DAWN FERREE (PA)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:FERREE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA
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 631863
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-1863
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8007 DISCOVERY DR STE A
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23229-8605
Practice Address - Country:US
Practice Address - Phone:804-287-3000
Practice Address - Fax:804-673-2731
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0110004928363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDS70387Medicare UPIN
MDKR52JHMedicare ID - Type UnspecifiedGROUP
MD490XMedicare ID - Type UnspecifiedINDIVIDUAL