Provider Demographics
NPI:1831166065
Name:MILLER, JEANNA ANNETTE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JEANNA
Middle Name:ANNETTE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:303 VINE ST
Mailing Address - Street 2:APT 508
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-1142
Mailing Address - Country:US
Mailing Address - Phone:215-349-8199
Mailing Address - Fax:215-662-7333
Practice Address - Street 1:3701 MARKET ST
Practice Address - Street 2:SUITE 640- ANTICOAGULATION CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5502
Practice Address - Country:US
Practice Address - Phone:215-349-8199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP439633183500000X
MD17541183500000X
GARPH022302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist