Provider Demographics
NPI:1831419951
Name:MILLER, JAIME N (PHARMD)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:N
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 1:7321 BALMER ST
Mailing Address - Street 2:BLDG 570
Mailing Address - City:HILL AFB
Mailing Address - State:UT
Mailing Address - Zip Code:84056
Mailing Address - Country:US
Mailing Address - Phone:801-777-0418
Mailing Address - Fax:801-586-9890
Practice Address - Street 1:7321 BALMER ST
Practice Address - Street 2:BLDG 570
Practice Address - City:HILL AFB
Practice Address - State:UT
Practice Address - Zip Code:84056-5012
Practice Address - Country:US
Practice Address - Phone:801-777-0418
Practice Address - Fax:801-586-9890
Is Sole Proprietor?:No
Enumeration Date:2010-06-11
Last Update Date:2010-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14642183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist