MEDICARE: MS. DEBRA JOAN MILLER FAMILY NURSE PRACTIT

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	363LF0000X	Family Nurse Practitioner	100118	MT

General Provider Information

NPI Number	:	1477596161
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DEBRA JOAN MILLER FAMILY NURSE PRACTIT

Provider Business Mailing Address
First Line	:	310 MAIN ST
Second Line	:
City	:	DEER LODGE
State	:	MT
Zip	:	59722-1000
Country	:	US
Telephone Number	:	406-846-4275
Fax Number	:	406-846-4278

Provider Business Practice Location Address
First Line	:	310 MAIN ST
Second Line	:
City	:	DEER LODGE
State	:	MT
Zip	:	59722-1000
Country	:	US
Telephone Number	:	406-846-4275
Fax Number	:	406-846-4278

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

Provider Enumeration Date	:	06/13/2006
Last Update Date	:	04/21/2017

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