Provider Demographics
NPI:1003317231
Name:MILLER, NIKKA JEAN
Entity Type:Individual
Prefix:
First Name:NIKKA
Middle Name:JEAN
Last Name:MILLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6992
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78683-6992
Mailing Address - Country:US
Mailing Address - Phone:512-317-3397
Mailing Address - Fax:
Practice Address - Street 1:2408 LYNX CT
Practice Address - Street 2:
Practice Address - City:PFLUGERVILLE
Practice Address - State:TX
Practice Address - Zip Code:78660-6571
Practice Address - Country:US
Practice Address - Phone:512-317-3397
Practice Address - Fax:512-317-3397
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX251C00000XOtherDAYHABILITATION
TX251C00000XOtherDAYHABILITATION