Individual
MICHELLE K MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
F.N.P.-C
Contact information
Practice address
777 S MAIN ST STE 100, CLINTON, IN 47842-2493
(765) 828-1003
Mailing address
250 N SHADELAND AVE, SUITE 130 - PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
(800) 732-1066
(317) 962-4343
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28179417A
IN
363L00000X
Nurse Practitioner
Primary
71003631A
IN
363LF0000X
Family Nurse Practitioner
209018042
IL
Other
Enumeration date
07/15/2011
Last updated
09/30/2021
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