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NPI Code Detail

MEDICARE: MELISSA MILLER RN

MEDICARE: MELISSA MILLER RN
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
1163W00000XRegistered Nurse710507TX

General Provider Information

NPI Number : 1255726246
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA MILLER RN
Provider Business Mailing Address
First Line : 209 S HOUSTON AVE
Second Line :
City : CAMERON
State : TX
Zip : 76520-3934
Country : US
Telephone Number : 254-697-7039
Fax Number : 254-697-4809
Provider Business Practice Location Address
First Line : 209 S HOUSTON AVE
Second Line :
City : CAMERON
State : TX
Zip : 76520-3934
Country : US
Telephone Number : 254-697-7039
Fax Number : 254-697-4809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2015
Last Update Date : 04/06/2015

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