Healthcare Provider Details

I. General information

NPI: 1285650036
Provider Name (Legal Business Name): RANDEE MILLER MSN APRN BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 07/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8424 NAAB ROAD SUITE 3P
INDIANAPOLIS IN
46260-1975
US

IV. Provider business mailing address

8424 NAAB ROAD SUITE 3P
INDIANAPOLIS IN
46260-1975
US

V. Phone/Fax

Practice location:
  • Phone: 317-608-6090
  • Fax: 317-876-1971
Mailing address:
  • Phone: 317-608-6090
  • Fax: 317-876-1971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71001160A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: