1023260452 NPI number — MRS. RAINI L. MILLER BSN, RN-BC, CSAC

Table of content: MRS. RAINI L. MILLER BSN, RN-BC, CSAC (NPI 1023260452)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023260452 NPI number — MRS. RAINI L. MILLER BSN, RN-BC, CSAC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER
Provider First Name:
RAINI
Provider Middle Name:
L.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
BSN, RN-BC, CSAC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1023260452
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/29/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
02/16/2012
NPI Reactivation Date:
08/29/2018

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
459 PATTERSON ROAD VA PACIFIC ISLANDS HEALTH CARE SYSTE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96819-1522
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-538-2518
Provider Business Mailing Address Fax Number:
808-839-1747

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
459 PATTERSON ROAD VA PACIFIC ISLANDS HEALTH CARE SYSTE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-1522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-538-2518
Provider Business Practice Location Address Fax Number:
808-839-1747
Provider Enumeration Date:
10/16/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WA0400X , with the licence number:  47601 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WC0400X , with the licence number: 47601 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WM0705X , with the licence number: 552162 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WP0809X , with the licence number: 47601 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WP0807X , with the licence number: 47601 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)