Healthcare Provider Details

I. General information

NPI: 1669395182
Provider Name (Legal Business Name): HALIE MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 MEMORIAL PKWY
RANDOLPH MA
02368-4505
US

IV. Provider business mailing address

43 CIDER MILL LN
UPTON MA
01568-1121
US

V. Phone/Fax

Practice location:
  • Phone: 781-437-4448
  • Fax:
Mailing address:
  • Phone: 503-833-2375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN2390567
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: