Provider Demographics
NPI:1740084490
Name:MILLER, MYKA VENEECE
Entity type:Individual
Prefix:
First Name:MYKA
Middle Name:VENEECE
Last Name:MILLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6795 SCHOOL BRANCH DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-7484
Mailing Address - Country:US
Mailing Address - Phone:317-514-6794
Mailing Address - Fax:
Practice Address - Street 1:6795 SCHOOL BRANCH DR
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-7484
Practice Address - Country:US
Practice Address - Phone:317-514-6794
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INHHA2403089374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty