Healthcare Provider Details

I. General information

NPI: 1982787107
Provider Name (Legal Business Name): CHRISTOPHER JAMES MILLER ND,MSN,APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1308 PROSPECT ST
INDIANAPOLIS IN
46203-1939
US

IV. Provider business mailing address

1308 PROSPECT ST
INDIANAPOLIS IN
46203-1939
US

V. Phone/Fax

Practice location:
  • Phone: 317-633-4666
  • Fax: 317-633-4671
Mailing address:
  • Phone: 317-633-4666
  • Fax: 317-633-4671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number70000082A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: