Provider Demographics
NPI:1740322668
Name:MILLER, CHRISTIANE MARCELLE (DEM)
Entity type:Individual
Prefix:MS
First Name:CHRISTIANE
Middle Name:MARCELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2952 NORTH 1375 EAST
Mailing Address - Street 2:
Mailing Address - City:NORTH OGDEN
Mailing Address - State:UT
Mailing Address - Zip Code:84414
Mailing Address - Country:US
Mailing Address - Phone:801-782-5339
Mailing Address - Fax:
Practice Address - Street 1:2952 N 1375 E
Practice Address - Street 2:
Practice Address - City:NORTH OGDEN
Practice Address - State:UT
Practice Address - Zip Code:84414-1850
Practice Address - Country:US
Practice Address - Phone:801-782-5339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife