Provider Demographics
NPI:1669407623
Name:MILLER, VICTORIA ANN (LPN)
Entity type:Individual
Prefix:MS
First Name:VICTORIA
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7190 HILLMONT DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054
Mailing Address - Country:US
Mailing Address - Phone:614-939-0125
Mailing Address - Fax:614-939-0125
Practice Address - Street 1:7190 HILLMONT DR
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:OH
Practice Address - Zip Code:43054-7024
Practice Address - Country:US
Practice Address - Phone:614-939-0125
Practice Address - Fax:614-939-0125
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPH059762363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2093121Medicaid