Provider Demographics
NPI:1881762284
Name:MILLER, BONITA MAE I
Entity type:Individual
Prefix:MS
First Name:BONITA
Middle Name:MAE
Last Name:MILLER
Suffix:I
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:BONITA
Other - Middle Name:MAE
Other - Last Name:MILLER
Other - Suffix:I
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:5039 OBERLIN BLVD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45237-5247
Mailing Address - Country:US
Mailing Address - Phone:513-242-4563
Mailing Address - Fax:513-242-4775
Practice Address - Street 1:5039 OBERLIN BLVD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45237-5247
Practice Address - Country:US
Practice Address - Phone:513-242-4563
Practice Address - Fax:513-242-4775
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN141462163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse