Healthcare Provider Details

I. General information

NPI: 1447177589
Provider Name (Legal Business Name): BRANDON TYLER MILLER APRN-CNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 PRINGLE WAY STE 900
RENO NV
89502-1464
US

IV. Provider business mailing address

1155 MILL ST # M14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-6270
  • Fax: 775-982-6271
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-6271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number841630
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: