Provider Demographics
NPI:1730193921
Name:MILLER, MICHELLE (OT)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:1818 E. 23RD
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1106
Mailing Address - Country:US
Mailing Address - Phone:620-662-6000
Mailing Address - Fax:620-669-2394
Practice Address - Street 1:1818 E. 23RD
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1106
Practice Address - Country:US
Practice Address - Phone:620-662-6000
Practice Address - Fax:620-669-2394
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1701308208100000X
KS17-01308208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSP00071036OtherRR MEDICARE PROV. NO.
KSP80844Medicare UPIN
P80844Medicare UPIN
KS013746Medicare ID - Type Unspecified