Provider Demographics
NPI:1780747907
Name:MILLER, SUE A (NP-C)
Entity type:Individual
Prefix:
First Name:SUE
Middle Name:A
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2523 W 109TH AVE
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-3154
Mailing Address - Country:US
Mailing Address - Phone:720-438-5990
Mailing Address - Fax:855-895-2818
Practice Address - Street 1:6455 S YOSEMITE ST
Practice Address - Street 2:6TH FLOOR
Practice Address - City:GREENWOOD VILLAGE
Practice Address - State:CO
Practice Address - Zip Code:80111-5139
Practice Address - Country:US
Practice Address - Phone:720-438-5990
Practice Address - Fax:877-245-5761
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0003118-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
COP21068Medicare UPIN