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General NPI Number Information
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NPI Number | 1235616293
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Entity Type | Individual
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Provider Name | NICOLE CHRISTINE MILLER ARNP
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Gender | Female
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 04/02/2020
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Provider Practice Location Address
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Address Line | 21 W JEFFERSON ST STE 103
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City | WATERLOO
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State | IA
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Zip | 50701-1341
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Country | US
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Telephone | 319-272-6100
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Fax | 319-272-6105
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Provider Business Mailing Address
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Address Line | 21 W JEFFERSON ST STE 103
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City | WATERLOO
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State | IA
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Zip | 50701-1341
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Country | US
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Telephone | 319-272-6100
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Fax | 319-272-6105
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | A126925
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License Number State | IA
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