Provider Demographics
NPI:1720777089
Name:MILLER, EMILY ALYSE
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ALYSE
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 1:8564 CYPRESS AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:COTATI
Mailing Address - State:CA
Mailing Address - Zip Code:94931-4335
Mailing Address - Country:US
Mailing Address - Phone:707-731-9172
Mailing Address - Fax:
Practice Address - Street 1:8564 CYPRESS AVE APT 2
Practice Address - Street 2:
Practice Address - City:COTATI
Practice Address - State:CA
Practice Address - Zip Code:94931-4335
Practice Address - Country:US
Practice Address - Phone:707-731-9172
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-03
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula