Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 11799 | NV |
Y | 208600000X | Surgeon | 11799 | NV |
N | 2086S0102X | Surgical Critical Care | 11799 | NV |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 11799 | NV |
NPI | 1053349977 |
---|---|
Provider Name | Dr. Mitzi M Miller |
First Address | Reno, NV 89502-0993 |
Second Address | Reno, NV 89502-0993 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2006 |
Last Update Date | 21/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G58590 | (02) | NV |