Summer Miller

Individual provider Active NPI Licensed Practical Nurse · Creswell, OR

NPI 1821398181 · NPPES record last updated Nov 2, 2010

Key facts

NPI
1821398181
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
201030430LPN (OR)
Practice address
33142 Camas Swale Rd
Creswell, OR 97426-9732
Phone
(541) 430-5230
NPI assigned
Nov 2, 2010
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

LicenseStateTypeSpecialty
201030430LPNORMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 201030430LPN OR Yes

Addresses

Primary practice location

33142 Camas Swale Rd
Creswell, OR 97426-9732

Mailing address

PO Box 191
Azalea, OR 97410-0191

Other providers in Creswell, OR

All providers in Creswell, OR · Licensed Practical Nurse in Oregon

Sources for this page

Verify at the official NPI Registry.