Healthcare Provider Details

I. General information

NPI: 1063835122
Provider Name (Legal Business Name): DAVIDA NICOLE MILLER DNP APRN FNP-C PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 MARSHALL RD SW
WINTER HAVEN FL
33880-1955
US

IV. Provider business mailing address

1651 MARSHALL RD SW
WINTER HAVEN FL
33880-1955
US

V. Phone/Fax

Practice location:
  • Phone: 510-650-2351
  • Fax:
Mailing address:
  • Phone: 510-650-2351
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number11009020
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number351087
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1131644
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3018844
License Number StateKY
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1010139728
License Number StateVT
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number408917
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number11009020
License Number StateFL
# 8
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number233429
License Number StateFL
# 9
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number233429
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: