Provider Demographics
NPI:1154676880
Name:MILLER, MICHELLE M (MSN, RN, ANP, OCN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:MILLER
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Gender:F
Credentials:MSN, RN, ANP, OCN
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Mailing Address - Street 1:8 BOULEVARD PKWY
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-5515
Mailing Address - Country:US
Mailing Address - Phone:585-734-9037
Mailing Address - Fax:
Practice Address - Street 1:601 ELMWOOD AVE
Practice Address - Street 2:BOX 704
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14642-0001
Practice Address - Country:US
Practice Address - Phone:585-275-5307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2023-07-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY3060712084P0804X
NYF306071-1363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry