Provider Demographics
NPI:1073246393
Name:MILLER, ANDREA N (APRN-CNP)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:N
Last Name:MILLER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 W I 35 FRONTAGE RD STE 170
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-8558
Mailing Address - Country:US
Mailing Address - Phone:405-757-3742
Mailing Address - Fax:405-757-3744
Practice Address - Street 1:2017 W I 35 FRONTAGE RD STE 170
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-8558
Practice Address - Country:US
Practice Address - Phone:405-757-3742
Practice Address - Fax:405-757-3744
Is Sole Proprietor?:No
Enumeration Date:2022-07-05
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0129629163W00000X
OK209679363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse