Miller, Etthan Charles

Miller, Etthan Charles is an individual health care provider with primary practice located at 1785 W Lee Hwy , Wytheville VA 24382-1437. He recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Emergency, Nursing Service Providers / Occupational Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Miller, Etthan Charles can be contacted via phone (276) 620-4246.

Contact Information

Primary practice address
1785 W Lee Hwy Wytheville VA 24382-1437
Phone: (276) 620-4246
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Emergency 163WE0003X 0001111520 Virginia
Nursing Service Providers / Occupational Health 163WX0106X 0001111520 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024172389 Virginia

Profile Details

NPI number 1336546209
LBN Legal business name Miller, Etthan Charles
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 20th, 2014
Last updated Nov 10th, 2017 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336546209 NPPES
Virginia MEDICAID 1336546209

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