Healthcare Provider Details

I. General information

NPI: 1134838055
Provider Name (Legal Business Name): ZACHARIAS MILLER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2022
Last Update Date: 07/16/2026
Certification Date: 07/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4610 S ULSTER ST STE 150
DENVER CO
80237-4326
US

IV. Provider business mailing address

132 DEER VALLEY DR
NEW CASTLE CO
81647-8526
US

V. Phone/Fax

Practice location:
  • Phone: 707-362-0625
  • Fax:
Mailing address:
  • Phone: 707-362-0625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95038792
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0998491
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: