MEDICARE: MRS. RANDEE MILLER MSN APRN BC

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
1	363LA2200X	Adult Health Nurse Practitioner	71001160A	IN

General Provider Information

NPI Number	:	1285650036
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RANDEE MILLER MSN APRN BC

Provider Business Mailing Address
First Line	:	8424 NAAB ROAD
Second Line	:	SUITE 3P
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-1975
Country	:	US
Telephone Number	:	317-608-6090
Fax Number	:	317-876-1971

Provider Business Practice Location Address
First Line	:	8424 NAAB ROAD
Second Line	:	SUITE 3P
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46260-1975
Country	:	US
Telephone Number	:	317-608-6090
Fax Number	:	317-876-1971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2006
Last Update Date	:	07/23/2010

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