MEDICARE: MRS. TARA LEA MILLER APRN, FNP-BC

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	66825	WV

General Provider Information

NPI Number	:	1750784732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TARA LEA MILLER APRN, FNP-BC

Provider Business Mailing Address
First Line	:	5113 BRIAR MEADOW RD
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25313-1261
Country	:	US
Telephone Number	:	304-552-8402
Fax Number	:	304-202-7879

Provider Business Practice Location Address
First Line	:	2406 KANAWHA BLVD E
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25311-2323
Country	:	US
Telephone Number	:	304-539-0342
Fax Number	:	304-202-7879

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

Provider Enumeration Date	:	10/03/2014
Last Update Date	:	11/10/2025

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