MEDICARE: MRS. ANGELA C MILLER NP

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	363L00000X	Nurse Practitioner	APO4571	LA

Other Identifiers

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

General Provider Information

NPI Number	:	1770671331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANGELA C MILLER NP

Provider Business Mailing Address
First Line	:	919 HIDDEN RDG
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-3813
Country	:	US
Telephone Number	:	469-282-2711
Fax Number	:	469-282-0996

Provider Business Practice Location Address
First Line	:	1701 JIMMIE DAVIS HWY
Second Line	:	SUITE 200
City	:	BOSSIER CITY
State	:	LA
Zip	:	71112-4515
Country	:	US
Telephone Number	:	318-681-1660
Fax Number	:	318-681-1661

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	12/10/2025

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