Provider Demographics
NPI:1235930090
Name:MILLER, CHRISTIE E
Entity type:Individual
Prefix:
First Name:CHRISTIE
Middle Name:E
Last Name:MILLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEW MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:45346-8761
Mailing Address - Country:US
Mailing Address - Phone:937-423-8628
Mailing Address - Fax:
Practice Address - Street 1:148 N MAIN ST
Practice Address - Street 2:
Practice Address - City:NEW MADISON
Practice Address - State:OH
Practice Address - Zip Code:45346-8761
Practice Address - Country:US
Practice Address - Phone:937-423-8628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-19
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1852563747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant