MEDICARE: MS. GARNETTE MILLER DNP FNP BC

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	2012019851	MO
2	363LF0000X	Family Nurse Practitioner	APN0000013748	TN
3	363LF0000X	Family Nurse Practitioner	810545	MS

General Provider Information

NPI Number	:	1891931069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. GARNETTE MILLER DNP FNP BC

Provider Business Mailing Address
First Line	:	1150 CASINO STRIP RESORT BLVD
Second Line	:
City	:	ROBINSONVILLE
State	:	MS
Zip	:	38664
Country	:	US
Telephone Number	:	662-357-7707
Fax Number	:	662-357-7807

Provider Business Practice Location Address
First Line	:	1150 CASINO STRIP RESORT BLVD
Second Line	:
City	:	ROBINSONVILLE
State	:	MS
Zip	:	38664
Country	:	US
Telephone Number	:	662-357-7707
Fax Number	:	662-357-7807

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

Provider Enumeration Date	:	12/18/2008
Last Update Date	:	02/28/2025

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