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General NPI Number Information
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NPI Number | 1740249515
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Entity Type | Individual
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Provider Name | TERRY WAYNE MILLER NP
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Gender | Male
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Dates
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Enumeration Date | 03/21/2006
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Last Update Date | 12/19/2016
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Provider Practice Location Address
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Address Line | 903 MISSISSIPPI DR
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City | TUPELO
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State | MS
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Zip | 38804-0928
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Country | US
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Telephone | 662-377-4652
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Fax | 662-377-4656
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Provider Business Mailing Address
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Address Line | 3411 W MAIN ST
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City | TUPELO
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State | MS
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Zip | 38801-9413
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Country | US
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Telephone | 662-377-4652
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Fax | 662-377-4656
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | R850611
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License Number State | MS
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