Trudy Ann Miller, LPN
Individual provider Active NPI Licensed Practical Nurse · Bloomfield, NY
NPI 1487786117 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1487786117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- 232627-1 (NY)
- Practice address
- 4 South Ave
Bloomfield, NY 14469-9200 - Phone
- (585) 657-4881
- NPI assigned
- Mar 9, 2007
- Sex
- Female
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 232627-1 | NY | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | 232627-1 | NY | Yes |
Addresses
Primary practice location
4 South Ave
Bloomfield, NY 14469-9200
Mailing address
4 South Ave
P.O.Box 618
Bloomfield, NY 14469-9200
Phone (585) 657-4881
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02225703 | Medicaid | NY |
Other providers in Bloomfield, NY
- Gillian Lynn Kingsley
- Adam Lake
- Fern Legters
- Chad Lipovsky
- Marybeth McConnell
- Jean Muller Rohland
- Gretchen A. Myers
- Anina Christine Olsen
- Bonnie J Pestle
- Randall K. Freeman, DDS
All providers in Bloomfield, NY · Licensed Practical Nurse in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.