Provider Demographics
NPI:1699654921
Name:MILLER, OLIVIA (PA-C)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 FURNACE LN
Mailing Address - Street 2:
Mailing Address - City:NEW FLORENCE
Mailing Address - State:PA
Mailing Address - Zip Code:15944-1162
Mailing Address - Country:US
Mailing Address - Phone:412-735-1972
Mailing Address - Fax:
Practice Address - Street 1:411 THEATRE DR
Practice Address - Street 2:
Practice Address - City:JOHNSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15904-2838
Practice Address - Country:US
Practice Address - Phone:814-266-3934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA066860363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant