Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 023139 | OH |
Y | 363LA2100X | Nurse Practitioner - Acute Care | APRN.CNP.023139 | OH |
NPI | 1104392281 |
---|---|
Provider Name | Iryna V Miller |
First Address | Columbus, OH 43222-1551 |
Second Address | Columbus, OH 43202-1523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2018 |
Last Update Date | 25/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0322961 | (05) | OH |