Individual
STACEY ANNE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103-6202
(610) 402-9099
(610) 402-9029
Mailing address
1245 S CEDAR CREST BLVD STE 301, ALLENTOWN, PA 18103-6258
(610) 402-9099
(610) 402-9029
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN581833
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
080007
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1027805940001
—
PA
01
—
11932981
CAQH
PA
01
—
121363
GEISINGER
PA
01
—
1585154
GATEWAY
PA
01
—
2073227
HIGHMARK
PA
01
—
3546644000
IBC
PA
01
—
50079236
CAPITAL ADVANTAGE
PA
01
—
9542451
AETNA
PA
Enumeration date
07/17/2008
Last updated
03/25/2013
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