Basic Information
Provider Information
NPI: 1720445315
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLER
FirstName: PAULA
MiddleName: ANN
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 320 E NORTH AVE
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152124756
CountryCode: US
TelephoneNumber: 4123593155
FaxNumber: 4123593483
Practice Location
Address1: 320 E NORTH AVE
Address2:  
City: PITTSBURGH
State: PA
PostalCode: 152124756
CountryCode: US
TelephoneNumber: 4123593155
FaxNumber: 4123593483
Other Information
ProviderEnumerationDate: 01/27/2016
LastUpdateDate: 10/04/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/04/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367500000XRN562166PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered 

No ID Information.


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