Most Relevant Information
Provider Data
| NPI Number: | 1003239310 |
| Provider Name: | MYKALENE MILLER |
| Entity Type: | Individual |
| Taxonomy Code: | 183700000X |
| Specialty: | Pharmacy Technician |
| License Number: | PT12678 |
Most Important Dates
| Enumeration Date: | 01/23/2014 |
| Last Updated: | 01/23/2014 |
Provider Practice Location
1559 WATASHEAMU RD
GARDNERVILLE
NV
894607455
Practice Location Phone/Fax
| Phone: | 7752654215 |
| Fax: | 7752659248 |
Provider Mailing Location
1559 WATASHEAMU RD
GARDNERVILLE
NV
894607455
Provider Mailing Phone/Fax
| Phone: | 7752654215 |
| Fax: | 7752659248 |