Provider Demographics
NPI:1730378696
Name:MILLER, PAMELA S (MSN NP)
Entity type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:S
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10880 WILSHIRE BOULEVARD
Mailing Address - Street 2:SUITE 860
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-7338
Mailing Address - Country:US
Mailing Address - Phone:310-267-0844
Mailing Address - Fax:310-267-4257
Practice Address - Street 1:10833 LECONTE AVENUE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095
Practice Address - Country:US
Practice Address - Phone:310-267-0844
Practice Address - Fax:310-267-4257
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA15169363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care