MEDICARE: VICTORIA MARIE MILLER 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
1	363L00000X	Nurse Practitioner	AP128685	TX

General Provider Information

NPI Number	:	1437535507
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA MARIE MILLER FNP

Provider Business Mailing Address
First Line	:	2770 AERO DR STE 3
Second Line	:
City	:	PORT ARTHUR
State	:	TX
Zip	:	77640-1519
Country	:	US
Telephone Number	:	409-237-5133
Fax Number	:

Provider Business Practice Location Address
First Line	:	2770 AERO DR STE 3
Second Line	:
City	:	PORT ARTHUR
State	:	TX
Zip	:	77640-1519
Country	:	US
Telephone Number	:	409-237-5133
Fax Number	:

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

Provider Enumeration Date	:	07/30/2015
Last Update Date	:	04/07/2026

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