Provider Demographics
NPI:1649623315
Name:MILLER, RACHEL NICOLE (PA)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:NICOLE
Last Name:MILLER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:NICOLE
Other - Last Name:JORDAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2222 ROSEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-2206
Mailing Address - Country:US
Mailing Address - Phone:512-465-4840
Mailing Address - Fax:512-465-4841
Practice Address - Street 1:2222 ROSEWOOD AVE
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-2206
Practice Address - Country:US
Practice Address - Phone:512-465-4840
Practice Address - Fax:512-465-4841
Is Sole Proprietor?:No
Enumeration Date:2016-07-18
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10619363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant