Healthcare Provider Details

I. General information

NPI: 1467282814
Provider Name (Legal Business Name): CAMMIE MARIE MILLER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2024
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1280 S VICTORIA AVE STE 250
VENTURA CA
93003-6521
US

IV. Provider business mailing address

1793 CALLE ROCAS
CAMARILLO CA
93010-8427
US

V. Phone/Fax

Practice location:
  • Phone: 805-351-0745
  • Fax:
Mailing address:
  • Phone: 805-335-7762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95031883
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: