Healthcare Provider Details

I. General information

NPI: 1316825912
Provider Name (Legal Business Name): SCHAMITRA MONIC MILLER WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/22/2025
Last Update Date: 08/22/2025
Certification Date: 08/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 AUTUMN FERN TRL
LILLINGTON NC
27546-5155
US

IV. Provider business mailing address

43 WILDLIFE BRIDGE CT
SPRING LAKE NC
28390-6701
US

V. Phone/Fax

Practice location:
  • Phone: 910-364-0971
  • Fax:
Mailing address:
  • Phone: 910-322-3809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number104733057
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: