Healthcare Provider Details

I. General information

NPI: 1124687462
Provider Name (Legal Business Name): RACHAEL LEA MILLER RN, NP, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RACHAEL LEA SPEARS

II. Dates (important events)

Enumeration Date: 06/11/2019
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1551 E SHAW AVE STE 139
FRESNO CA
93710-8025
US

IV. Provider business mailing address

1707 EYE ST # 100
BAKERSFIELD CA
93301-5208
US

V. Phone/Fax

Practice location:
  • Phone: 559-320-0490
  • Fax:
Mailing address:
  • Phone: 613-103-6886
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95023582
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95180773
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number14-127624-062
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2013036996
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2019017374
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: