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General NPI Number Information
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NPI Number | 1487285839
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Entity Type | Individual
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Provider Name | KATY LOUISE MILLER APRN
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Gender | Female
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Dates
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Enumeration Date | 02/03/2020
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Last Update Date | 10/03/2024
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Provider Practice Location Address
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Address Line | 4225 WOODBINE RD
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City | PACE
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State | FL
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Zip | 32571-8790
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Country | US
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Telephone | 850-994-6575
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Fax | 850-994-3313
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Provider Business Mailing Address
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Address Line | 405 BELCHER ST
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City | CENTREVILLE
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State | AL
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Zip | 35042-2946
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Country | US
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Telephone | 205-926-2992
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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 | 1-173703
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11032265
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1-173703
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License Number State | AL
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