MEDICARE: TRACEY DEANN MILLER APRN

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	363LP2300X	Primary Care Nurse Practitioner	NP 626A	ID

General Provider Information

NPI Number	:	1942210208
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACEY DEANN MILLER APRN

Provider Business Mailing Address
First Line	:	1775 SPRING CREEK DR
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59102-6754
Country	:	US
Telephone Number	:	406-373-3584
Fax Number	:	406-373-3550

Provider Business Practice Location Address
First Line	:	1775 SPRING CREEK DR
Second Line	:
City	:	BILLINGS
State	:	MT
Zip	:	59102-6754
Country	:	US
Telephone Number	:	406-373-3584
Fax Number	:	406-373-3550

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

Provider Enumeration Date	:	08/09/2006
Last Update Date	:	03/24/2017

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