MEDICARE: BRIAN L. MILLER CNP

Medicare Provider Information

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	CP000273	SD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

NPI Number	:	1699770073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN L. MILLER CNP

Provider Business Mailing Address
First Line	:	PO BOX 5074
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57117-5074
Country	:	US
Telephone Number	:	605-328-6585
Fax Number	:	605-328-6512

Provider Business Practice Location Address
First Line	:	7220 W 41ST ST
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57106-6028
Country	:	US
Telephone Number	:	605-332-2883
Fax Number	:	605-328-9620

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

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	05/22/2014

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax: