Provider Demographics
NPI:1558196659
Name:MILLER, MEGAN ROSE (APRN)
Entity type:Individual
Prefix:MS
First Name:MEGAN
Middle Name:ROSE
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 1:5473 N UNIVERSITY DR APT 1605
Mailing Address - Street 2:
Mailing Address - City:LAUDERHILL
Mailing Address - State:FL
Mailing Address - Zip Code:33351-5176
Mailing Address - Country:US
Mailing Address - Phone:305-915-4284
Mailing Address - Fax:
Practice Address - Street 1:5473 N UNIVERSITY DR APT 1605
Practice Address - Street 2:
Practice Address - City:LAUDERHILL
Practice Address - State:FL
Practice Address - Zip Code:33351-5176
Practice Address - Country:US
Practice Address - Phone:305-915-4284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-06
Last Update Date:2024-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11035115363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health