Healthcare Provider Details

I. General information

NPI: 1619804549
Provider Name (Legal Business Name): MEGHAN NICOLLE MILLER BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 E COPLIN ST
OKEMAH OK
74859-4642
US

IV. Provider business mailing address

124 N 10TH ST
OKEMAH OK
74859-2202
US

V. Phone/Fax

Practice location:
  • Phone: 918-623-1424
  • Fax:
Mailing address:
  • Phone: 539-299-1107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number218901
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: