Provider Demographics
NPI:1982949152
Name:MILLER, JAMIE P (RN)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:P
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 1:1642 LEGEND HILL LN
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53189-8088
Mailing Address - Country:US
Mailing Address - Phone:414-405-3189
Mailing Address - Fax:
Practice Address - Street 1:1642 LEGEND HILL LN
Practice Address - Street 2:
Practice Address - City:WAUKESHA
Practice Address - State:WI
Practice Address - Zip Code:53189-8088
Practice Address - Country:US
Practice Address - Phone:414-405-3189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2012-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI189894-30163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse