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General NPI Number Information
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NPI Number | 1508510082
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Entity Type | Individual
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Provider Name | JESSICA RACHELLE MILLER NP
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Gender | Female
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Dates
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Enumeration Date | 02/04/2022
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Last Update Date | 01/04/2024
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Provider Practice Location Address
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Address Line | 1050 REID PKWY STE 325
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City | RICHMOND
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State | IN
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Zip | 47374-1161
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Country | US
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Telephone | 765-962-8551
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Fax |
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Provider Business Mailing Address
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Address Line | 2588 S SALEM RD
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City | LIBERTY
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State | IN
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Zip | 47353-8905
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Country | US
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Telephone | 765-580-0342
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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 | 28207662A
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License Number State | IN
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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 | 71012580A
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License Number State | IN
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