Healthcare Provider Details

I. General information

NPI: 1063936540
Provider Name (Legal Business Name): AMY L MILLER AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 04/24/2025
Certification Date: 04/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 GLEN COVE DR
WOODLAND PARK CO
80863-7001
US

IV. Provider business mailing address

3200 DOVER DR
PLANO TX
75075-3397
US

V. Phone/Fax

Practice location:
  • Phone: 214-620-5424
  • Fax: 855-715-9478
Mailing address:
  • Phone: 214-620-5424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364SA2200X
TaxonomyAdult Health Clinical Nurse Specialist
License NumberAP134511
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAP134511
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1063936540
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: