Provider Demographics
NPI:1568906188
Name:MILLER, HEATHER ANN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CROSSROADS DR STE 306
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5437
Mailing Address - Country:US
Mailing Address - Phone:443-738-2889
Mailing Address - Fax:443-471-8540
Practice Address - Street 1:9245 PARK WEST BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4425
Practice Address - Country:US
Practice Address - Phone:865-690-3811
Practice Address - Fax:865-694-7621
Is Sole Proprietor?:No
Enumeration Date:2016-12-16
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009120363LF0000X
TN21769363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily