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NPI Code Detail

MEDICARE: MELISSA JANE MILLER RN, APRN, AGPCNP-BC

MEDICARE: MELISSA JANE MILLER RN, APRN, AGPCNP-BC
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
1363L00000XNurse PractitionerAP125396TX

General Provider Information

NPI Number : 1992118301
Entity Type Code : Individual
Provider Name (Legal Business Name) : MELISSA JANE MILLER RN, APRN, AGPCNP-BC
Provider Business Mailing Address
First Line : 4009 WORTH ST
Second Line :
City : DALLAS
State : TX
Zip : 75246-1608
Country : US
Telephone Number : 214-820-9115
Fax Number : 214-820-9135
Provider Business Practice Location Address
First Line : 4009 WORTH ST
Second Line :
City : DALLAS
State : TX
Zip : 75246-1608
Country : US
Telephone Number : 214-820-9115
Fax Number : 214-820-9135
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2014
Last Update Date : 04/06/2022

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