Active NPI
Jacquelyn Michele Miller
- Pharmacy Technician
- Saint Charles, MO
National Provider Identifier
1174914600
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- 2011026978
- Practice address
- 3881 Mexico Road
Saint Charles, MO 63303 - Phone
- (636) 922-3064
- NPI assigned
- Feb 5, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | 2011026978 | MO | Primary |
Addresses
Primary practice location
3881 Mexico Road
Saint Charles, MO 63303
Mailing address
4 Oakn Bend LN
Saint Peters, MO 63376
Phone (314) 799-7897
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2011026978 | MO | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423094400000",
"number": "1174914600",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4 OAKN BEND LN",
"city": "SAINT PETERS",
"state": "MO",
"postal_code": "63376",
"telephone_number": "314-799-7897"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3881 MEXICO ROAD",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "63303",
"telephone_number": "636-922-3064"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JACQUELYN",
"middle_name": "MICHELE",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-05",
"last_updated": "2015-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "MO",
"license": "2011026978",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Charles, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.