Provider Demographics
NPI:1932357647
Name:MILLER, ERIN DILORENZO (PA)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:DILORENZO
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:JEAN
Other - Last Name:DILORENZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:BANNER MD ANDERSON
Mailing Address - Street 2:2940 E BANNER GATEWAY DR. STE 450
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234
Mailing Address - Country:US
Mailing Address - Phone:480-256-6444
Mailing Address - Fax:480-256-3682
Practice Address - Street 1:BANNER MD ANDERSON CANCER CENTER
Practice Address - Street 2:2946 E. BANNER GATEWAY DR.
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234
Practice Address - Country:US
Practice Address - Phone:480-256-6444
Practice Address - Fax:480-256-3682
Is Sole Proprietor?:No
Enumeration Date:2008-09-05
Last Update Date:2021-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ5723363A00000X
CAPA19894363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant