Provider Demographics
NPI:1841871654
Name:MILLER, ADAM SCOT (MSN RN)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:SCOT
Last Name:MILLER
Suffix:
Gender:M
Credentials:MSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 E THOMAS RD UNIT 233
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-1182
Mailing Address - Country:US
Mailing Address - Phone:970-379-7995
Mailing Address - Fax:
Practice Address - Street 1:200 E THOMAS RD UNIT 233
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-1182
Practice Address - Country:US
Practice Address - Phone:970-379-7995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-15
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ199987163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care MedicineGroup - Single Specialty