Provider Demographics
NPI:1871748160
Name:MILLER, ROXANN DENISE (RN, MS, GNP, MS, BC)
Entity type:Individual
Prefix:
First Name:ROXANN
Middle Name:DENISE
Last Name:MILLER
Suffix:
Gender:F
Credentials:RN, MS, GNP, MS, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 FIELDWOOD DR
Mailing Address - Street 2:ROCHESTER
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14609-2540
Mailing Address - Country:US
Mailing Address - Phone:585-467-1025
Mailing Address - Fax:
Practice Address - Street 1:339 FIELDWOOD DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14609-2540
Practice Address - Country:US
Practice Address - Phone:585-467-1025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-01
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY505586163W00000X
NY340666163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology
No163W00000XNursing Service ProvidersRegistered Nurse