=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083756803
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NAOMI MILLER CNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2007
-----------------------------------------------------
Last Update Date | 10/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1526 E MAIN ST
-----------------------------------------------------
City | MELBOURNE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72556-9315
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-368-4344
-----------------------------------------------------
Fax | 870-368-3051
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1710 HARRISON ST
-----------------------------------------------------
City | BATESVILLE
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72501-7303
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 870-262-1200
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | A01226
-----------------------------------------------------
License Number State | AR
-----------------------------------------------------