Healthcare Provider Details

I. General information

NPI: 1053475194
Provider Name (Legal Business Name): CATHERINE MILLER NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 04/05/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 PINE LAKE RD STE 5
LINCOLN NE
68516-5489
US

IV. Provider business mailing address

PO BOX 67250
LINCOLN NE
68506-7250
US

V. Phone/Fax

Practice location:
  • Phone: 402-328-8833
  • Fax:
Mailing address:
  • Phone: 402-413-6706
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCP000479
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number945
License Number StateAK
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number111111
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: