Provider Demographics
NPI:1740506328
Name:MILLER, BERNADETTE (RN)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:BERNADETTE
Other - Middle Name:
Other - Last Name:SCHILLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:38 MOUNTAIN REST RD.
Mailing Address - Street 2:
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-2917
Mailing Address - Country:US
Mailing Address - Phone:845-255-9162
Mailing Address - Fax:
Practice Address - Street 1:38 MOUNTAIN REST RD.
Practice Address - Street 2:
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-2917
Practice Address - Country:US
Practice Address - Phone:845-527-8472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-08
Last Update Date:2010-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226981-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02723742Medicaid