Provider Demographics
NPI:1053724948
Name:MILLER, CAROLYN ELAINE
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:ELAINE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:OH
Mailing Address - Zip Code:44001-1609
Mailing Address - Country:US
Mailing Address - Phone:440-985-7448
Mailing Address - Fax:
Practice Address - Street 1:163 PEARL ST
Practice Address - Street 2:
Practice Address - City:AMHERST
Practice Address - State:OH
Practice Address - Zip Code:44001-1609
Practice Address - Country:US
Practice Address - Phone:440-985-7448
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide