=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528399748
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TARA L MILLER ARNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/28/2010
-----------------------------------------------------
Last Update Date | 08/20/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 28720 US HIGHWAY 98 STE 1
-----------------------------------------------------
City | DAPHNE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36526-7268
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-241-4346
-----------------------------------------------------
Fax | 251-241-4356
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 109 PEBBLE CT
-----------------------------------------------------
City | FAIRHOPE
-----------------------------------------------------
State | AL
-----------------------------------------------------
Zip | 36532-6326
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 251-241-4346
-----------------------------------------------------
Fax | 251-241-4356
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 9299613
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 1-124579
-----------------------------------------------------
License Number State | AL
-----------------------------------------------------