Provider Demographics
NPI:1669191623
Name:MILLER, RAYMOND DEAN (APRN)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:DEAN
Last Name:MILLER
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 33269
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85067-3269
Mailing Address - Country:US
Mailing Address - Phone:602-406-4786
Mailing Address - Fax:916-636-4358
Practice Address - Street 1:1955 W FRYE RD
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-6282
Practice Address - Country:US
Practice Address - Phone:480-909-3870
Practice Address - Fax:602-230-6462
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2024-12-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ279110363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care