Provider Demographics
NPI:1982386454
Name:MILLER, LORA BETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:LORA
Middle Name:BETH
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29990 HORSETHIEF DR
Mailing Address - Street 2:
Mailing Address - City:TEHACHAPI
Mailing Address - State:CA
Mailing Address - Zip Code:93561-5437
Mailing Address - Country:US
Mailing Address - Phone:661-435-2795
Mailing Address - Fax:
Practice Address - Street 1:20406 BRIAN WAY STE 3C
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-6756
Practice Address - Country:US
Practice Address - Phone:661-435-2795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-03
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA789136163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant