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NPI Code Detail

MEDICARE: TANYA M MILLER ARNP

MEDICARE: TANYA M MILLER ARNP
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
1363LA2200XAdult Health Nurse PractitionerARNP9234723FL

General Provider Information

NPI Number : 1154674158
Entity Type Code : Individual
Provider Name (Legal Business Name) : TANYA M MILLER ARNP
Provider Business Mailing Address
First Line : 3434 HANCOCK BRIDGE PKWY
Second Line : STE 301
City : NORTH FORT MYERS
State : FL
Zip : 33903-7094
Country : US
Telephone Number : 877-856-3774
Fax Number : 239-599-2625
Provider Business Practice Location Address
First Line : 13214 PALM BEACH BLVD
Second Line :
City : FORT MYERS
State : FL
Zip : 33905-2025
Country : US
Telephone Number : 239-694-7887
Fax Number : 239-694-8941
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/16/2012
Last Update Date : 10/19/2016

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