Healthcare Provider Details

I. General information

NPI: 1942435177
Provider Name (Legal Business Name): LORI ANN MILLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI ANN RUSHKOWSKI

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 11/24/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11725 ILLINOIS ST STE 240
CARMEL IN
46032-3011
US

IV. Provider business mailing address

PO BOX 778912
CHICAGO IL
60677-8912
US

V. Phone/Fax

Practice location:
  • Phone: 317-944-3774
  • Fax: 317-944-8521
Mailing address:
  • Phone: 317-777-6435
  • Fax: 317-777-6644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0222X
TaxonomyCritical Care Pediatric Nurse Practitioner
License Number71002929A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number71002929A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number28160748A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: