Provider Demographics
NPI:1235851817
Name:MILLER, MATTHEW JOSHUA (FNP)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:JOSHUA
Last Name:MILLER
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 PRECINCT LINE RD # 2976
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76182-4815
Mailing Address - Country:US
Mailing Address - Phone:817-485-2113
Mailing Address - Fax:
Practice Address - Street 1:6401 PRECINCT LINE RD # 2976
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76182-4815
Practice Address - Country:US
Practice Address - Phone:817-485-2113
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049952363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily