MEDICARE: SUSAN BLESSMAN MILLER R.N., M.S., F.N.P.C.

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	524779	TX

General Provider Information

NPI Number	:	1801076153
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUSAN BLESSMAN MILLER R.N., M.S., F.N.P.C.

Provider Business Mailing Address
First Line	:	4909 W PARK BLVD STE 177
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-2311
Country	:	US
Telephone Number	:	972-955-2263
Fax Number	:	972-521-3215

Provider Business Practice Location Address
First Line	:	4909 W PARK BLVD STE 177
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75093-2311
Country	:	US
Telephone Number	:	972-955-2263
Fax Number	:	972-521-3215

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

Provider Enumeration Date	:	11/04/2007
Last Update Date	:	01/25/2024

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