Basic Information
| Provider Information | |||||||||
| NPI: | 1760719728 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | MELANIE | ||||||||
| MiddleName: | C | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 480 GALLETTI WAY | ||||||||
| Address2: | |||||||||
| City: | SPARKS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894315564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7756882001 | ||||||||
| FaxNumber: | 7756882004 | ||||||||
| Practice Location | |||||||||
| Address1: | 480 GALLETTI WAY | ||||||||
| Address2: | |||||||||
| City: | SPARKS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894315564 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7756882001 | ||||||||
| FaxNumber: | 7756882004 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/12/2009 | ||||||||
| LastUpdateDate: | 11/12/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN49493 | NV | Y | Nursing Service Providers | Registered Nurse |
ID Information
| ID | Type | State | Issuer | Description | RN49493 | 01 | NV | REGISTERED NURSE | OTHER |