Provider Demographics
NPI:1255530580
Name:MILLER, MELINDA F (MSN, CRNP)
Entity type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:F
Last Name:MILLER
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 EAST CAMPUS AVE.
Mailing Address - Street 2:HERON POINT OF CHESTERTOWN WELLNESS CENTER
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620
Mailing Address - Country:US
Mailing Address - Phone:410-778-7300
Mailing Address - Fax:410-810-2731
Practice Address - Street 1:501 E CAMPUS AVE
Practice Address - Street 2:HERON POINT OF CHESTERTOWN WELLNESS CENTER
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-1696
Practice Address - Country:US
Practice Address - Phone:410-778-7300
Practice Address - Fax:410-810-2731
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR085034363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC129474Medicare PIN
MD129474R57Medicare UPIN
MD129474YRVMedicare UPIN