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Contact Information

ETTHAN C MILLER
360 VIRGINIA AVE STE A
WYTHEVILLE, VA24382-1185
 Phone: 276-620-4246
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Emergency

163WE0003X
 

Occupational Health

163WX0106X
Indicates primary specialty

NPI Profile & details for ETTHAN C MILLER · (Male)

NPI Number 1336546209
Status Active
Credentials
Entity Individual
Enumeration date 11/20/2014
Last updated 05/01/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • VA License # 0001111520
  • VA License # 0024172389
  • VA Medicaid 1336546209
Hospital affiliation(s)
  • CARILION NEW RIVER VALLEY MEDICAL CENTER - (Acute Care)
    2900 LAMB CIRCLE
    CHRISTIANSBURG, VA 24073
  • WYTHE COUNTY COMMUNITY HOSPITAL - (Acute Care)
    600 WEST RIDGE ROAD
    WYTHEVILLE, VA 24382
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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