MEDICARE: ROBERT JEFFREY MILLER APRN-CNP

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	363LG0600X	Gerontology Nurse Practitioner	227977	OK
2	363LA2100X	Acute Care Nurse Practitioner	227977	OK

General Provider Information

NPI Number	:	1679429500
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT JEFFREY MILLER APRN-CNP

Provider Business Mailing Address
First Line	:	10505 E 91ST ST STE 205
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-5829
Country	:	US
Telephone Number	:	918-307-5490
Fax Number	:

Provider Business Practice Location Address
First Line	:	10505 E 91ST ST STE 205
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74133-5829
Country	:	US
Telephone Number	:	918-307-5490
Fax Number	:

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

Provider Enumeration Date	:	03/04/2026
Last Update Date	:	03/04/2026

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