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General NPI Number Information
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NPI Number | 1154674158
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Entity Type | Individual
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Provider Name | TANYA M MILLER ARNP
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Gender | Female
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Dates
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Enumeration Date | 10/16/2012
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Last Update Date | 10/19/2016
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Provider Practice Location Address
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Address Line | 13214 PALM BEACH BLVD
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City | FORT MYERS
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State | FL
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Zip | 33905-2025
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Country | US
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Telephone | 239-694-7887
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Fax | 239-694-8941
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Provider Business Mailing Address
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Address Line | 3434 HANCOCK BRIDGE PKWY STE 301
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City | NORTH FORT MYERS
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State | FL
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Zip | 33903-7094
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Country | US
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Telephone | 877-856-3774
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Fax | 239-599-2625
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP9234723
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License Number State | FL
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