Provider Demographics
NPI:1114331675
Name:MILLER, NANCY HOPPER (NP-C)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:HOPPER
Last Name:MILLER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10071 HIGHWAY 385
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70607-8672
Mailing Address - Country:US
Mailing Address - Phone:337-905-2151
Mailing Address - Fax:337-905-2155
Practice Address - Street 1:10071 HIGHWAY 385
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70607-8672
Practice Address - Country:US
Practice Address - Phone:337-905-2151
Practice Address - Fax:337-905-2155
Is Sole Proprietor?:No
Enumeration Date:2014-06-12
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN065592-AP03207363LF0000X
LAAP03207363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily