Provider Demographics
NPI:1770159519
Name:MILLER, ANNE MARITA (RN)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:MARITA
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7129 CCC ROAD
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:WI
Mailing Address - Zip Code:54830-8741
Mailing Address - Country:US
Mailing Address - Phone:320-291-1873
Mailing Address - Fax:
Practice Address - Street 1:7129 CCC ROAD
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:WI
Practice Address - Zip Code:54830-8741
Practice Address - Country:US
Practice Address - Phone:320-291-1873
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-02
Last Update Date:2021-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI259092163WH0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health