Provider Demographics
NPI:1811244734
Name:MILLER, ADRIANE ELLEN (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:ADRIANE
Middle Name:ELLEN
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3037 BROOKFIELD DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IA
Mailing Address - Zip Code:52302-4781
Mailing Address - Country:US
Mailing Address - Phone:319-373-2017
Mailing Address - Fax:
Practice Address - Street 1:3037 BROOKFIELD DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IA
Practice Address - Zip Code:52302-4781
Practice Address - Country:US
Practice Address - Phone:319-373-2017
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA21721183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist