Miller, Maranda
Miller, Maranda is an individual health care provider with primary practice located at 2357 W Mason St , Green Bay WI 54303-4708. She recently has only one registered license in Nursing Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Miller, Maranda can be contacted via phone (920) 337-6740.Contact Information
Primary practice address
2357 W Mason St
Green Bay WI 54303-4708
Phone: (920) 337-6740
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Addiction (Substance Use Disorder) | 163WA0400X | 234343-30 | Wisconsin |
Profile Details
| NPI number | 1356839724 |
|---|---|
| LBN Legal business name | Miller, Maranda |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 1st, 2018 |
| Last updated | May 1st, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1356839724 | NPPES |
| Wisconsin | MEDICAID | 42030700 |
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