MEDICARE: BRITTANY LYNN MILLER FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	104106	WV

General Provider Information

NPI Number	:	1114571668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANY LYNN MILLER FNP-BC

Provider Business Mailing Address
First Line	:	354 COMMERCE DR
Second Line	:
City	:	BEAVER
State	:	WV
Zip	:	25813-8985
Country	:	US
Telephone Number	:	304-250-0150
Fax Number	:	304-250-0153

Provider Business Practice Location Address
First Line	:	354 COMMERCE DR
Second Line	:
City	:	BEAVER
State	:	WV
Zip	:	25813-8985
Country	:	US
Telephone Number	:	304-250-0150
Fax Number	:	304-250-0153

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2019
Last Update Date	:	09/28/2022

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