1992857270 NPI number — DR. TRISHA R MILLER PH.D.

Table of content: DR. TRISHA R MILLER PH.D. (NPI 1992857270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992857270 NPI number — DR. TRISHA R MILLER PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLER
Provider First Name:
TRISHA
Provider Middle Name:
R
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
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:
1992857270
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
580 UPWARD RD
Provider Second Line Business Mailing Address:
UNIT 1
Provider Business Mailing Address City Name:
FLAT ROCK
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28731-8592
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-696-3531
Provider Business Mailing Address Fax Number:
828-696-0952

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
580 UPWARD RD
Provider Second Line Business Practice Location Address:
UNIT 1
Provider Business Practice Location Address City Name:
FLAT ROCK
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28731-8592
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-696-3531
Provider Business Practice Location Address Fax Number:
828-696-0952
Provider Enumeration Date:
01/17/2007

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: 103TC0700X , with the licence number:  PP2526 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103T00000X , with the licence number: 2526 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 015R6 . This is a "BCBS OF NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 6000144 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2088658 . This is a "CIGNA BEHAVIORAL HEALTH" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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