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Individual

EILEEN MARY MILLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
385 WEST MAIN STREET, AVON, CT 06001
(860) 777-1280
Mailing address
1290 SILAS DEANE HWY, HHC CVO ENROLLMENT 1ST FLOOR, WETHERSFIELD, CT 06109-4337
(860) 972-6970

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
289585-1
NY
363L00000X
Nurse Practitioner
F342266-1
NY
363LF0000X
Family Nurse Practitioner
Primary
007457
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
007457
CT LIC
CT
Enumeration date
10/15/2007
Last updated
07/23/2021
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