MEDICARE: ELLE CLAIRE HEEG 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	363LF0000X	Family Nurse Practitioner	APN.0993780-NP	CO

General Provider Information

NPI Number	:	1497242168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELLE CLAIRE HEEG MILLER

Provider Business Mailing Address
First Line	:	2611 N RACE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-4551
Country	:	US
Telephone Number	:	715-514-9888
Fax Number	:

Provider Business Practice Location Address
First Line	:	2611 N RACE ST
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80205-4551
Country	:	US
Telephone Number	:	715-514-9888
Fax Number	:

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

Provider Enumeration Date	:	04/18/2018
Last Update Date	:	04/18/2018

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