Provider Demographics
NPI:1639996234
Name:MILLER, DONNA DARLENE
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:DARLENE
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 1:103 KETTLE ST
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26534
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:103 KETTLE ST
Practice Address - Street 2:
Practice Address - City:GRANVILLE
Practice Address - State:WV
Practice Address - Zip Code:26534
Practice Address - Country:US
Practice Address - Phone:681-867-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide