Provider Demographics
NPI:1861817025
Name:MILLER, LINDA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:DUNCANSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7305 BREN LN
Mailing Address - Street 2:
Mailing Address - City:EDEN PRAIRIE
Mailing Address - State:MN
Mailing Address - Zip Code:55346-4136
Mailing Address - Country:US
Mailing Address - Phone:612-280-2530
Mailing Address - Fax:
Practice Address - Street 1:7305 BREN LN
Practice Address - Street 2:
Practice Address - City:EDEN PRAIRIE
Practice Address - State:MN
Practice Address - Zip Code:55346-4136
Practice Address - Country:US
Practice Address - Phone:612-280-2530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor