Provider Demographics
NPI:1407819717
Name:MILLER, NICOLE F (CRNP)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:F
Last Name:MILLER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 S 7TH AVE
Mailing Address - Street 2:SUITE 340
Mailing Address - City:WEST READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-1410
Mailing Address - Country:US
Mailing Address - Phone:610-375-6565
Mailing Address - Fax:610-375-2065
Practice Address - Street 1:301 S 7TH AVE
Practice Address - Street 2:SUITE 340
Practice Address - City:WEST READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1410
Practice Address - Country:US
Practice Address - Phone:610-375-6565
Practice Address - Fax:610-375-2065
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP-008294363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA082514Medicare ID - Type Unspecified
PAQ22416Medicare UPIN