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NPI Code Detail

MEDICARE: LAYNE MILLER JR. FNP-C

MEDICARE:   LAYNE  MILLER JR. FNP-C
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
1363L00000XNurse Practitioner13687MN

General Provider Information

NPI Number : 1467314112
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAYNE MILLER JR. FNP-C
Provider Business Mailing Address
First Line : 1300 ANNE ST NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5103
Country : US
Telephone Number : 218-333-4680
Fax Number :
Provider Business Practice Location Address
First Line : 1300 ANNE ST NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5103
Country : US
Telephone Number : 218-333-4680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2025
Last Update Date : 12/02/2025

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Directions to “ LAYNE MILLER JR. FNP-C” Practice Location

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