Provider Demographics
NPI:1043800758
Name:MILLER, DEANNA (NP)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BERNARD ST
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-1906
Mailing Address - Country:US
Mailing Address - Phone:201-873-8593
Mailing Address - Fax:
Practice Address - Street 1:479 COUNTY RTE 520
Practice Address - Street 2:SUITE 101-B BUILDING B
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746
Practice Address - Country:US
Practice Address - Phone:732-856-5999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01089000363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily