Provider Demographics
NPI:1255039087
Name:MILLER MEDICAL CARE LLC
Entity type:Organization
Organization Name:MILLER MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:NEDRA
Authorized Official - Middle Name:JOLYN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:A-APRN, FNP
Authorized Official - Phone:727-478-0648
Mailing Address - Street 1:5341 GRAND BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34652-4004
Mailing Address - Country:US
Mailing Address - Phone:727-478-0648
Mailing Address - Fax:727-478-0618
Practice Address - Street 1:5341 GRAND BLVD STE 105
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34652-4004
Practice Address - Country:US
Practice Address - Phone:727-478-0648
Practice Address - Fax:727-478-0618
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-21
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility