MEDICARE: TRACIA MILLER APRN, FNP-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	APRN11034547	FL
2	363LF0000X	Family Nurse Practitioner	32457	TX
3	363LF0000X	Family Nurse Practitioner	71015671A	IN
4	363LF0000X	Family Nurse Practitioner	2024032091	MO
5	363LF0000X	Family Nurse Practitioner	0036655	OH
6	363LF0000X	Family Nurse Practitioner	AP143993	TX

General Provider Information

NPI Number	:	1861028771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACIA MILLER APRN, FNP-C

Provider Business Mailing Address
First Line	:	508 MAIS DR
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-3050
Country	:	US
Telephone Number	:	512-247-8598
Fax Number	:

Provider Business Practice Location Address
First Line	:	3651 E BASELINE RD STE 230
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85234-5450
Country	:	US
Telephone Number	:	888-880-3451
Fax Number	:

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

Provider Enumeration Date	:	03/23/2020
Last Update Date	:	05/29/2025

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