Provider Demographics
NPI:1366219289
Name:MILLER, BRIGETTE AMBER
Entity type:Individual
Prefix:
First Name:BRIGETTE
Middle Name:AMBER
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 1:2439 PORTAGE HOLLOW DR
Mailing Address - Street 2:
Mailing Address - City:MOGADORE
Mailing Address - State:OH
Mailing Address - Zip Code:44260-1817
Mailing Address - Country:US
Mailing Address - Phone:330-356-6796
Mailing Address - Fax:
Practice Address - Street 1:2439 PORTAGE HOLLOW DR
Practice Address - Street 2:
Practice Address - City:MOGADORE
Practice Address - State:OH
Practice Address - Zip Code:44260-1817
Practice Address - Country:US
Practice Address - Phone:330-356-6796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251X00000XAgenciesSupports Brokerage
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No376J00000XNursing Service Related ProvidersHomemaker