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General NPI Number Information
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NPI Number | 1639832553
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Entity Type | Individual
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Provider Name | MISTY S MILLER FNP
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Gender | Female
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Dates
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Enumeration Date | 10/18/2021
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Last Update Date | 09/08/2022
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Provider Practice Location Address
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Address Line | 6567 E CARONDELET DR STE 305
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City | TUCSON
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State | AZ
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Zip | 85710-6160
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Country | US
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Telephone | 520-881-8400
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Fax |
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Provider Business Mailing Address
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Address Line | 3241 N RIVERBEND PL
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City | TUCSON
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State | AZ
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Zip | 85750-2570
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 264484
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License Number State | AZ
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