Healthcare Provider Details

I. General information

NPI: 1104177997
Provider Name (Legal Business Name): LYNDA CHARLENE MILLER DNP,FNP-C,PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2012
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

878 FOX DR
WINCHESTER VA
22603-8613
US

IV. Provider business mailing address

878 FOX DR
WINCHESTER VA
22603-8613
US

V. Phone/Fax

Practice location:
  • Phone: 540-546-2624
  • Fax: 540-696-5421
Mailing address:
  • Phone: 540-546-2624
  • Fax: 540-696-5421

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number0024170388
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024170388
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: