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General NPI Number Information
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NPI Number | 1790769990
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Entity Type | Individual
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Provider Name | DEBORAH K MILLER CNM FNP
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Gender | Female
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 11/10/2022
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Provider Practice Location Address
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Address Line | 2500 STATE RD # 33
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City | LA CROSSE
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State | WI
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Zip | 54601-5098
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Country | US
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Telephone | 608-775-5858
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Fax |
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Provider Business Mailing Address
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Address Line | 1836 SOUTH AVE
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City | LA CROSSE
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State | WI
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Zip | 54601-5429
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Country | US
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Telephone | 608-782-7300
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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 | 2743
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License Number State | MN
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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 | 024002622
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | R0974974
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License Number State | MN
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 12169
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License Number State | WI
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