MEDICARE: KAITLIN MILLER MSN, RN

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	163W00000X	Registered Nurse	249712-30	WI

General Provider Information

NPI Number	:	1659229466
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAITLIN MILLER MSN, RN

Provider Business Mailing Address
First Line	:	W277N2770 CHICORY LN
Second Line	:
City	:	PEWAUKEE
State	:	WI
Zip	:	53072-4392
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	W277N2770 CHICORY LN
Second Line	:
City	:	PEWAUKEE
State	:	WI
Zip	:	53072-4392
Country	:	US
Telephone Number	:	330-620-7769
Fax Number	:

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

Provider Enumeration Date	:	03/18/2026
Last Update Date	:	03/18/2026

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