Healthcare Provider Details

I. General information

NPI: 1831538776
Provider Name (Legal Business Name): MORGAN MICHELLE MILLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2013
Last Update Date: 04/20/2020
Certification Date: 04/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1824 N STATE HIGHWAY CC STE B
NIXA MO
65714-8015
US

IV. Provider business mailing address

PO BOX 397
NIXA MO
65714-0397
US

V. Phone/Fax

Practice location:
  • Phone: 417-719-4541
  • Fax: 417-893-3908
Mailing address:
  • Phone: 417-865-1547
  • Fax: 417-862-2571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2013020271
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: