Healthcare Provider Details

I. General information

NPI: 1730639063
Provider Name (Legal Business Name): ALYSSA CARIN MILLER APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALYSSA CARIN HUDDLESTON

II. Dates (important events)

Enumeration Date: 10/11/2016
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4143 SUN N LAKE BLVD
SEBRING FL
33872-2131
US

IV. Provider business mailing address

4143 SUN N LAKE BLVD
SEBRING FL
33872-2131
US

V. Phone/Fax

Practice location:
  • Phone: 863-386-6480
  • Fax: 863-386-6497
Mailing address:
  • Phone: 863-386-6480
  • Fax: 863-386-6497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number21858
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number21858
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN11020018
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code364SG0600X
TaxonomyGerontology Clinical Nurse Specialist
License Number21858
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: