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General NPI Number Information
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NPI Number | 1356607469
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Entity Type | Individual
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Provider Name | DR. NICHOLE THERESE MILLER
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Gender | Female
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Dates
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Enumeration Date | 04/03/2012
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 2932 AMBASSADOR CAFFERY PKWY STE B
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City | LAFAYETTE
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State | LA
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Zip | 70506-6756
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Country | US
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Telephone | 337-470-3080
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Fax | 337-470-3099
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Provider Business Mailing Address
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Address Line | 5959 S SHERWOOD FOREST BLVD
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City | BATON ROUGE
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State | LA
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Zip | 70816-6038
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Country | US
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Telephone | 337-470-3080
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Fax | 225-765-9196
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD.207219
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License Number State | LA
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