Individual
MRS. GRACE DOMINIQUE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
371 E 51ST ST, BROOKLYN, NY 11203-3507
(917) 651-5138
Mailing address
604 JEFFERSON AVE APT 3, BROOKLYN, NY 11221-7331
(516) 939-3005
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
761864
NY
163WH0200X
Home Health Registered Nurse
761864
NY
163WM0705X
Medical-Surgical Registered Nurse
761864
NY
164W00000X
Licensed Practical Nurse
314147
NY
Other
Enumeration date
07/24/2014
Last updated
12/01/2022
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