Healthcare Provider Details

I. General information

NPI: 1972655090
Provider Name (Legal Business Name): ANN MARIE NYE MILLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN MARIE NYE MD

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 DUBLIN BLVD
DUBLIN CA
94568-3112
US

IV. Provider business mailing address

319 LENNON LN
WALNUT CREEK CA
94598-2418
US

V. Phone/Fax

Practice location:
  • Phone: 925-946-1607
  • Fax:
Mailing address:
  • Phone: 925-946-1607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG82080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: