Healthcare Provider Details

I. General information

NPI: 1770051187
Provider Name (Legal Business Name): CARA DANIELLE MILLER FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/05/2018
Last Update Date: 01/07/2022
Certification Date: 02/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3705 FM 1488
SPRING TX
77385
US

IV. Provider business mailing address

10 SPLIT RAIL PL
SPRING TX
77382-2585
US

V. Phone/Fax

Practice location:
  • Phone: 866-389-2727
  • Fax:
Mailing address:
  • Phone: 713-249-2086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP139578
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: