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NPI Code Detail

MEDICARE: DEDRA MILLER NEWTON FNP

MEDICARE: DEDRA MILLER NEWTON FNP
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
1363LF0000XFamily Nurse PractitionerAP04603LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1386671519
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEDRA MILLER NEWTON FNP
Provider Business Mailing Address
First Line : 4660 BLUEBONNET BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-9632
Country : US
Telephone Number : 225-767-8550
Fax Number : 225-767-8556
Provider Business Practice Location Address
First Line : 4660 BLUEBONNET BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-9632
Country : US
Telephone Number : 225-767-8550
Fax Number : 225-767-8556
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2006
Last Update Date : 02/08/2022

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