Healthcare Provider Details

I. General information

NPI: 1194559849
Provider Name (Legal Business Name): ASHLEY MEGAN MILLER APN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2024
Last Update Date: 08/30/2024
Certification Date: 08/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12600 W COLFAX AVE STE B200
LAKEWOOD CO
80215-3736
US

IV. Provider business mailing address

4818 E 147TH AVE
THORNTON CO
80602-8557
US

V. Phone/Fax

Practice location:
  • Phone: 303-993-1330
  • Fax:
Mailing address:
  • Phone: 303-598-4938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAPN.1000100-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: