Healthcare Provider Details

I. General information

NPI: 1285304733
Provider Name (Legal Business Name): MADELINE VIRGINIA MILLER MSN, APRN, PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2021
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

461 21ST AVE S
NASHVILLE TN
37240-1104
US

IV. Provider business mailing address

1712 MARTIN ST
NASHVILLE TN
37203-5529
US

V. Phone/Fax

Practice location:
  • Phone: 603-660-8675
  • Fax:
Mailing address:
  • Phone: 603-660-8375
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-21-173759
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number289416
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: