Healthcare Provider Details

I. General information

NPI: 1972985331
Provider Name (Legal Business Name): MELISSA MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 HARRISON AVE STE 600
BOSTON MA
02111-1995
US

IV. Provider business mailing address

6532 S KELLERMAN WAY
AURORA CO
80016-6199
US

V. Phone/Fax

Practice location:
  • Phone: 657-500-0634
  • Fax:
Mailing address:
  • Phone: 719-994-9166
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number65781
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPN.0991160-NP
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: