Healthcare Provider Details
I. General information
NPI: 1023748639
Provider Name (Legal Business Name): CHERYL LEAH MILLER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 06/15/2022
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
173 E SPRINGBROOK RD
BROADWAY VA
22815-9526
US
IV. Provider business mailing address
173 E SPRINGBROOK RD
BROADWAY VA
22815-9526
US
V. Phone/Fax
- Phone: 540-901-7028
- Fax:
- Phone: 540-901-7028
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0000X |
| Taxonomy | Pain Medicine Physician |
| License Number | 0024184482 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 0024184482 |
| License Number State | VA |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 0024184482 |
| License Number State | VA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: