Provider Demographics
NPI:1235988080
Name:MILLER, NATASHA LYNN (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:NATASHA
Middle Name:LYNN
Last Name:MILLER
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 SYCAMORE LN
Mailing Address - Street 2:
Mailing Address - City:PALMYRA
Mailing Address - State:PA
Mailing Address - Zip Code:17078-2838
Mailing Address - Country:US
Mailing Address - Phone:717-839-7076
Mailing Address - Fax:
Practice Address - Street 1:16 SYCAMORE LN
Practice Address - Street 2:
Practice Address - City:PALMYRA
Practice Address - State:PA
Practice Address - Zip Code:17078-2838
Practice Address - Country:US
Practice Address - Phone:717-839-7076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-15
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN743279163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse