Provider Demographics
NPI:1720835937
Name:MILLER, PETYA TODOROVA
Entity Type:Individual
Prefix:
First Name:PETYA
Middle Name:TODOROVA
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:PETYA
Other - Middle Name:T
Other - Last Name:BECKETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:87 ELM ST
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1905
Mailing Address - Country:US
Mailing Address - Phone:330-559-1488
Mailing Address - Fax:
Practice Address - Street 1:87 ELM ST
Practice Address - Street 2:
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-1905
Practice Address - Country:US
Practice Address - Phone:330-559-1488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-06
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker