| Doctor Name: | MS. ROXANNE MILLER SIDES |
| NPI Number: | 1174708218 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | SP009693 |
| Business Practice Address: | 680 Blair Mill Rd Horsham, PA - 190442223 |
| Business Phone Number: | 8662979232 |
| Business Fax Number: | |
| Mailing Address: | 514 Farnum Rd, MEDIA |
| State: | PA |
| Postal Code: | 190631610 |
| Phone Number: | 6105662975 |
| Fax Number: | |
| NPI Enumeration Date: | 01/08/2008 |
| NPI Last Update Date: | 05/09/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | SP009693 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |