MEDICARE: ERIN MCCRACKEN 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN.CNP.023586	OH

General Provider Information

NPI Number	:	1740763200
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN MCCRACKEN MILLER

Provider Business Mailing Address
First Line	:	1080 NIMITZVIEW DR STE 102
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-4331
Country	:	US
Telephone Number	:	614-562-8548
Fax Number	:	513-450-7474

Provider Business Practice Location Address
First Line	:	1080 NIMITZVIEW DR STE 102
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45230-4331
Country	:	US
Telephone Number	:	614-562-8548
Fax Number	:	513-450-7474

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

Provider Enumeration Date	:	09/11/2018
Last Update Date	:	11/25/2024

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