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NPI Code Detail

MEDICARE: JESSICA LYNN MILLER

MEDICARE: JESSICA LYNN 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
1106S00000XBehavior TechnicianRBT-20-141878

General Provider Information

NPI Number : 1841871308
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA LYNN MILLER
Provider Business Mailing Address
First Line : 7901 E 88TH ST
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46256-1235
Country : US
Telephone Number : 317-849-5437
Fax Number :
Provider Business Practice Location Address
First Line : 1341 OHIO ST
Second Line :
City : TERRE HAUTE
State : IN
Zip : 47807-3940
Country : US
Telephone Number : 812-478-5437
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2021
Last Update Date : 04/16/2021

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Directions to “ JESSICA LYNN MILLER ” Practice Location

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