Healthcare Provider Details

I. General information

NPI: 1497124762
Provider Name (Legal Business Name): PHILLIP A MILLER FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E ADMIRAL DOYLE DR STE A
NEW IBERIA LA
70560-6711
US

IV. Provider business mailing address

600 JEFFERSON ST STE 600
LAFAYETTE LA
70501-6987
US

V. Phone/Fax

Practice location:
  • Phone: 337-376-0515
  • Fax:
Mailing address:
  • Phone: 337-202-0720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number236038
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: