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NPI Code Detail

MEDICARE: TYLER D MILLER APRN

MEDICARE: TYLER D MILLER APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner3012741KY

General Provider Information

NPI Number : 1124591318
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER D MILLER APRN
Provider Business Mailing Address
First Line : PO BOX 645996
Second Line :
City : CINCINNATI
State : OH
Zip : 45264-5996
Country : US
Telephone Number : 270-651-4444
Fax Number : 270-651-4892
Provider Business Practice Location Address
First Line : 106 COLUMNS PLAZA DR
Second Line :
City : GLASGOW
State : KY
Zip : 42141-8068
Country : US
Telephone Number : 270-651-9390
Fax Number : 270-651-8698
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2019
Last Update Date : 10/03/2023

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