Provider Demographics
NPI:1730338625
Name:MILLER, ANN MARIE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:MARIE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 GLENSTONE DR UNIT 701
Mailing Address - Street 2:
Mailing Address - City:GRIMES
Mailing Address - State:IA
Mailing Address - Zip Code:50111-2289
Mailing Address - Country:US
Mailing Address - Phone:857-753-7792
Mailing Address - Fax:
Practice Address - Street 1:5700 GLENSTONE DR
Practice Address - Street 2:UNIT 701
Practice Address - City:GRIMES
Practice Address - State:IA
Practice Address - Zip Code:50111
Practice Address - Country:US
Practice Address - Phone:857-753-7792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-16
Last Update Date:2008-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20495183500000X
MA0266901835N0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835N0905XPharmacy Service ProvidersPharmacistNuclear