Basic Information
Provider Information
NPI: 1225161482
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLER
FirstName: EVA
MiddleName: KATHRYN
NamePrefix:  
NameSuffix:  
Credential: MD, MPH
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: MEDICAL STAFF OFFICE VANDERBILT CHILDREN'S HOSPITAL
Address2: ROOM 2510 VCH, 2200 CHILDREN'S WAY
City: NASHVILLE
State: TN
PostalCode: 372320001
CountryCode: US
TelephoneNumber: 6153224916
FaxNumber:  
Practice Location
Address1: 2601 TVC
Address2:  
City: NASHVILLE
State: TN
PostalCode: 372320001
CountryCode: US
TelephoneNumber: 6153224916
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/14/2007
LastUpdateDate: 05/01/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2080P0201XMD0000042223TNY Allopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology

No ID Information.


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