Provider Demographics
NPI:1770549859
Name:MILLER, MARGARET (RNC NNP)
Entity type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:RNC NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:721 EDGEFIELD RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-1023
Mailing Address - Country:US
Mailing Address - Phone:817-625-0688
Mailing Address - Fax:
Practice Address - Street 1:1400 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2112
Practice Address - Country:US
Practice Address - Phone:817-882-2892
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX255746363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal