MEDICARE: KRYSTAL 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	363LF0000X	Family Nurse Practitioner	11046661	FL

General Provider Information

NPI Number	:	1760326912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRYSTAL MILLER

Provider Business Mailing Address
First Line	:	3545 NW 29TH ST
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33311-1844
Country	:	US
Telephone Number	:	954-663-0229
Fax Number	:

Provider Business Practice Location Address
First Line	:	3545 NW 29TH ST
Second Line	:
City	:	LAUDERDALE LAKES
State	:	FL
Zip	:	33311-1844
Country	:	US
Telephone Number	:	954-663-0229
Fax Number	:

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

Provider Enumeration Date	:	04/17/2026
Last Update Date	:	04/17/2026

Similar Medicare Providers

1396009858 — THERESA R O'DONNELL APNP
Practice Location Address:

2221 NE 33RD AVE
FORT LAUDERDALE, FL
33305-1844

Practice Phone: 305-799-7669
Practice Fax: 267-573-3198

1265180426 — ELEGANT HOME CARE INC
Practice Location Address:

150 SE 12TH ST STE 401-4
FORT LAUDERDALE, FL
33316-1844

Practice Phone: 347-906-1519
Practice Fax:

1558560615 — KENNETH JOHN WOLOSZ DC
Practice Location Address:

413 WANAQUE AVE
POMPTON LAKES, NJ
07442-1844

Practice Phone: 973-831-7703
Practice Fax: 973-831-6763

1417149816 — MR. STAFFORD WENDELL BARTON LPC
Practice Location Address:

413 WANAQUE AVE , SECOND FLOOR (LTC)
POMPTON LAKES, NJ
07442-1844

Practice Phone: 973-718-4344
Practice Fax: 973-718-4344

1649729955 — DEBRA EISENSTEIN-VERRET
Practice Location Address:

413 WANAQUE AVE , SUITE 5
POMPTON LAKES, NJ
07442-1844

Practice Phone: 973-487-8244
Practice Fax:

1225708886 — ACTIVELIFE REGENERATIVE THERAPIES
Practice Location Address:

413 WANAQUE AVE
POMPTON LAKES, NJ
07442-1844

Practice Phone: 973-997-0542
Practice Fax: 973-831-6763

Directions to “ KRYSTAL MILLER ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.