Healthcare Provider Details

I. General information

NPI: 1588326037
Provider Name (Legal Business Name): MONICA RACHELLE MILLER MS, CRNP, FNP-C, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2021
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 N MAIN ST
UNION BRIDGE MD
21791-9102
US

IV. Provider business mailing address

685 SKYLINE WAY
WESTMINSTER MD
21157-2913
US

V. Phone/Fax

Practice location:
  • Phone: 443-937-6258
  • Fax: 949-404-6023
Mailing address:
  • Phone: 410-982-3330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR189696
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR189696
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: