Provider Demographics
NPI:1043965817
Name:MILLER, AMANDA LYNETTE (BSW)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LYNETTE
Last Name:MILLER
Suffix:
Gender:F
Credentials:BSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 MANNINGTON CT
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8198
Mailing Address - Country:US
Mailing Address - Phone:859-248-1165
Mailing Address - Fax:
Practice Address - Street 1:301 MANNINGTON CT
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-8198
Practice Address - Country:US
Practice Address - Phone:859-248-1165
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-19
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator