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NPI Code Detail

MEDICARE: CHELSEA MILLER CRNP

MEDICARE: CHELSEA MILLER CRNP
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 Practitioner26NJ01224800NJ

General Provider Information

NPI Number : 1720743826
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHELSEA MILLER CRNP
Provider Business Mailing Address
First Line : 34 BOONTON AVE APT A
Second Line :
City : BUTLER
State : NJ
Zip : 07405-1346
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1144 E RIDGEWOOD AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-3941
Country : US
Telephone Number : 201-444-0020
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2021
Last Update Date : 11/03/2021

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