Jacob Daniel Miller
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Slippery Rock, PA
NPI 1063135960 · NPPES record last updated Sep 26, 2022
Key facts
- NPI
- 1063135960
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 106 Fairview Dr Apt 103
Slippery Rock, PA 16057-1542 - Phone
- (330) 221-0835
- NPI assigned
- Sep 26, 2022
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
106 Fairview Dr Apt 103
Slippery Rock, PA 16057-1542
Mailing address
106 Fairview Dr Apt 103
Slippery Rock, PA 16057-1542
Phone (330) 221-0835
Other providers in Slippery Rock, PA
- Katherine Jane McCormick
- Michael A McDonald
- Kara McDougall
- Adam McDowell
- Gretchen Marie McGowan
- Katie Montgomery
- Ned Moore
- Pedro Luis Morales Jr.
- Kayla Murray
- Megan Renee Nash
All providers in Slippery Rock, PA · Student in an Organized Health Care Education/Training Program in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.