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NPI Code Detail

MEDICARE: DR. NICHOLE THERESE MILLER

MEDICARE: DR. NICHOLE THERESE MILLER
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
1207Q00000XFamily Medicine PhysicianMD.207219LA

General Provider Information

NPI Number : 1356607469
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NICHOLE THERESE MILLER
Provider Business Mailing Address
First Line : 5959 S SHERWOOD FOREST BLVD
Second Line :
City : BATON ROUGE
State : LA
Zip : 70816-6038
Country : US
Telephone Number : 337-470-3080
Fax Number : 225-765-9196
Provider Business Practice Location Address
First Line : 2932 AMBASSADOR CAFFERY PKWY STE B
Second Line :
City : LAFAYETTE
State : LA
Zip : 70506-6756
Country : US
Telephone Number : 337-470-3080
Fax Number : 337-470-3099
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2012
Last Update Date : 09/09/2025

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