Provider Demographics
NPI:1871127548
Name:MILLER, HANNAH GRACE
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:GRACE
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:83 FOLEY RD
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-9642
Mailing Address - Country:US
Mailing Address - Phone:802-318-3627
Mailing Address - Fax:
Practice Address - Street 1:263 ALDEN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01109-3788
Practice Address - Country:US
Practice Address - Phone:802-318-3627
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-02
Last Update Date:2020-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program