MEDICARE: LEILA MILLER PA-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
1	363A00000X	Physician Assistant	PA2013-0072	NM
2	363A00000X	Physician Assistant	6672	AZ
3	363A00000X	Physician Assistant	15-02485	KS
4	363A00000X	Physician Assistant	085-004036	IL
5	363A00000X	Physician Assistant	0110011222	VA

General Provider Information

NPI Number	:	1568746139
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LEILA MILLER PA-C

Provider Business Mailing Address
First Line	:	7450 KESSLER ST STE 130
Second Line	:
City	:	MERRIAM
State	:	KS
Zip	:	66204-2550
Country	:	US
Telephone Number	:	913-722-0020
Fax Number	:	816-559-7118

Provider Business Practice Location Address
First Line	:	1232 PERIMETER PKWY STE 104
Second Line	:
City	:	VIRGINIA BEACH
State	:	VA
Zip	:	23454-5924
Country	:	US
Telephone Number	:	757-442-7213
Fax Number	:

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

Provider Enumeration Date	:	09/30/2011
Last Update Date	:	08/18/2025

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Directions to “ LEILA MILLER PA-C” Practice Location

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