Individual
DESTINEE MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
14677 MERRILL AVE, FONTANA, CA 92335-4219
(909) 728-2366
(909) 728-2366
Mailing address
14677 MERRILL AVE, FONTANA, CA 92335-4219
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
748861
CA
Other
Enumeration date
08/22/2025
Last updated
08/22/2025
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