MEDICARE: MRS. NANCY KNIGHT MILLER MSW, LCSW

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	1041C0700X	Clinical Social Worker	01974-C	NV
2	1041C0700X	Clinical Social Worker	34004464A	IN

General Provider Information

NPI Number	:	1326567603
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. NANCY KNIGHT MILLER MSW, LCSW

Provider Business Mailing Address
First Line	:	1411 S WOODLAND AVE STE B
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-7170
Country	:	US
Telephone Number	:	219-879-8580
Fax Number	:	219-809-0254

Provider Business Practice Location Address
First Line	:	1411 S WOODLAND AVE STE B
Second Line	:
City	:	MICHIGAN CITY
State	:	IN
Zip	:	46360-7170
Country	:	US
Telephone Number	:	219-879-8580
Fax Number	:	219-809-0254

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

Provider Enumeration Date	:	09/18/2017
Last Update Date	:	07/21/2022

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