Healthcare Provider Details

I. General information

NPI: 1043281199
Provider Name (Legal Business Name): LAURA L MILLER CFNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2006
Last Update Date: 12/01/2025
Certification Date: 12/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4049 S CAMPBELL AVE
SPRINGFIELD MO
65807-5303
US

IV. Provider business mailing address

4049 S CAMPBELL AVE
SPRINGFIELD MO
65807-5303
US

V. Phone/Fax

Practice location:
  • Phone: 417-890-5550
  • Fax: 417-889-6898
Mailing address:
  • Phone: 417-890-5550
  • Fax: 417-889-6898

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95034535
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN096032
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2094
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number096032
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: