Provider Demographics
NPI:1174778757
Name:MILLER, DOROTHY IRENE (ARNP)
Entity type:Individual
Prefix:MRS
First Name:DOROTHY
Middle Name:IRENE
Last Name:MILLER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 12TH STREET EXTENTSION
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2329
Mailing Address - Country:US
Mailing Address - Phone:304-425-9541
Mailing Address - Fax:304-431-2856
Practice Address - Street 1:200 12TH STREET EXTENTSION
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2329
Practice Address - Country:US
Practice Address - Phone:304-425-9541
Practice Address - Fax:304-431-2856
Is Sole Proprietor?:No
Enumeration Date:2008-11-24
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2095202101YM0800X
FLARNP 2095202101YM0800X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLARNP 2095202OtherFLORIDA STATE LICENSE NUMBER