Individual
BEVERLY JANE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1001 DELAFIELD ST, APT 320, WAUKESHA, WI 53188
(262) 547-6869
Mailing address
1110 N HARTWELL AVE, UPPR, WAUKESHA, WI 53186-3814
(262) 893-1278
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
29122031
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
35000300
—
WI
Enumeration date
06/06/2007
Last updated
07/08/2007
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