Healthcare Provider Details

I. General information

NPI: 1790155778
Provider Name (Legal Business Name): ASHLEY M MILLER ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9131 COLLEGE POINTE CT
FORT MYERS FL
33919
US

IV. Provider business mailing address

PO BOX 2147
FORT MYERS FL
33902-2147
US

V. Phone/Fax

Practice location:
  • Phone: 239-343-9100
  • Fax: 239-343-9108
Mailing address:
  • Phone: 239-343-9800
  • Fax: 239-343-9848

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP9294242
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9294242
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: