MEDICARE: TYESHIA MILLER DNP, APRN, PMHNP-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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	0024192789	VA

General Provider Information

NPI Number	:	1194523225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TYESHIA MILLER DNP, APRN, PMHNP-BC

Provider Business Mailing Address
First Line	:	516 INNOVATION DR STE 305
Second Line	:
City	:	CHESAPEAKE
State	:	VA
Zip	:	23320-3866
Country	:	US
Telephone Number	:	757-606-1377
Fax Number	:

Provider Business Practice Location Address
First Line	:	2340 COMMONWEALTH DR
Second Line	:
City	:	CHARLOTTESVILLE
State	:	VA
Zip	:	22901-1634
Country	:	US
Telephone Number	:	757-716-8184
Fax Number	:	732-272-0127

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

Provider Enumeration Date	:	03/05/2025
Last Update Date	:	01/23/2026

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