MEDICARE: MRS. SIERRA NICOLE MILLER

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1275480626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SIERRA NICOLE MILLER

Provider Business Mailing Address
First Line	:	712 WINDSOR AVE
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47710-3952
Country	:	US
Telephone Number	:	812-213-7350
Fax Number	:

Provider Business Practice Location Address
First Line	:	7313 EAGLE CREST BLVD
Second Line	:
City	:	EVANSVILLE
State	:	IN
Zip	:	47715-8157
Country	:	US
Telephone Number	:	812-213-7350
Fax Number	:

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

Provider Enumeration Date	:	03/13/2026
Last Update Date	:	03/13/2026

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