Provider Demographics
NPI:1942210208
Name:MILLER, TRACEY DEANN (APRN)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:DEANN
Last Name:MILLER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1775 SPRING CREEK DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-6754
Mailing Address - Country:US
Mailing Address - Phone:406-373-3584
Mailing Address - Fax:406-373-3550
Practice Address - Street 1:1775 SPRING CREEK DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6754
Practice Address - Country:US
Practice Address - Phone:406-373-3584
Practice Address - Fax:406-373-3550
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2017-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP 626A363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care