Provider Demographics
NPI:1861550808
Name:MILLER, ROBERT EDWARD (RN)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:EDWARD
Last Name:MILLER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:6720 LINDA SUE WAY
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3024
Mailing Address - Country:US
Mailing Address - Phone:916-847-4570
Mailing Address - Fax:916-965-8956
Practice Address - Street 1:3230 PEACEKEEPER WAY BLDG 209
Practice Address - Street 2:
Practice Address - City:MCCLELLAN
Practice Address - State:CA
Practice Address - Zip Code:95652-2600
Practice Address - Country:US
Practice Address - Phone:916-830-1526
Practice Address - Fax:916-929-1861
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA560859163WC0200X, 163WC0400X, 163WC1600X, 163WE0003X, 163WF0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WE0003XNursing Service ProvidersRegistered NurseEmergency
No163WF0300XNursing Service ProvidersRegistered NurseFlight