MEDICARE: NANCY JO MILLER RDN

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	133V00000X	Registered Dietitian	0199	SD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	854027	OTHER		COMMISSION ON DIETETIC REGISTRATIONS (CDR

General Provider Information

NPI Number	:	1952911877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY JO MILLER RDN

Provider Business Mailing Address
First Line	:	4210 W 53RD ST
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57106-4257
Country	:	US
Telephone Number	:	605-322-1484
Fax Number	:

Provider Business Practice Location Address
First Line	:	4210 W 53RD ST
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57106-4257
Country	:	US
Telephone Number	:	605-322-1490
Fax Number	:

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

Provider Enumeration Date	:	08/05/2020
Last Update Date	:	03/11/2026

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