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General NPI Number Information
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NPI Number | 1235665316
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Entity Type | Individual
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Provider Name | HEATHER LYNN MILLER FNP
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Gender | Female
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Dates
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Enumeration Date | 05/10/2017
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Last Update Date | 09/30/2025
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Provider Practice Location Address
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Address Line | 1603 WENTZVILLE PKWY
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City | WENTZVILLE
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State | MO
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Zip | 63385-3826
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Country | US
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Telephone | 636-332-8228
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 955534
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City | SAINT LOUIS
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State | MO
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Zip | 63195-5534
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Country | US
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Telephone |
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Fax |
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2011003712
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2016033642
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License Number State | MO
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