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General NPI Number Information
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NPI Number | 1275385643
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Entity Type | Organization
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Legal Business Name | LAVERTTA MILLER APRN LLC
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Dates
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Enumeration Date | 04/01/2024
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Last Update Date | 04/01/2024
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Provider Practice Location Address
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Address Line | 2430 VANDERBILT BEACH RD STE 108-573
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City | NAPLES
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State | FL
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Zip | 34109-2654
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Country | US
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Telephone | 239-427-5541
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Fax |
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Provider Business Mailing Address
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Address Line | 821 VISTANA CIR
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City | NAPLES
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State | FL
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Zip | 34119-1004
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Country | US
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Telephone | 870-805-9625
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | LAVERTTA K MILLER
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Credential | NP
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Telephone | 239-427-5541
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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 |
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License Number State |
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