Provider Demographics
NPI:1245041391
Name:MILLER, PAIGE MAKENNA (BSN RN)
Entity type:Individual
Prefix:
First Name:PAIGE
Middle Name:MAKENNA
Last Name:MILLER
Suffix:
Gender:F
Credentials:BSN RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HEIDELBERG FARMS LN
Mailing Address - Street 2:
Mailing Address - City:BERNVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19506-9552
Mailing Address - Country:US
Mailing Address - Phone:610-568-2651
Mailing Address - Fax:
Practice Address - Street 1:1700 S LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042-7529
Practice Address - Country:US
Practice Address - Phone:610-568-2651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN797926163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse