Provider Demographics
NPI:1023364973
Name:MILLER, MELISSA MICHELLE (FNP)
Entity type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:MICHELLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3533 S. ALAMEDA SUITE 301
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411
Mailing Address - Country:US
Mailing Address - Phone:361-694-4700
Mailing Address - Fax:361-694-4701
Practice Address - Street 1:3533 S. ALAMEDA SUITE 301
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411
Practice Address - Country:US
Practice Address - Phone:361-694-4700
Practice Address - Fax:361-694-4701
Is Sole Proprietor?:No
Enumeration Date:2012-07-30
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX741369363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily