Basic Information
Provider Information
NPI: 1912578527
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILLER
FirstName: ALLISON
MiddleName: FAITH
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 501 S WASHINGTON AVE STE 1000
Address2:  
City: SCRANTON
State: PA
PostalCode: 185053814
CountryCode: US
TelephoneNumber: 5703432383
FaxNumber: 5703433923
Practice Location
Address1: 103 SPRUCE ST
Address2:  
City: HAWLEY
State: PA
PostalCode: 184281149
CountryCode: US
TelephoneNumber: 5705768081
FaxNumber: 5702300013
Other Information
ProviderEnumerationDate: 07/06/2021
LastUpdateDate: 07/06/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XRN657918PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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