Individual
REAGAN COLETTE MILLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
3800 SAINT MARY RD STE 102, VALPARAISO, IN 46383-3986
(219) 286-3707
(219) 286-3708
Mailing address
8558 BROADWAY, MERRILLVILLE, IN 46410-7032
(219) 392-7084
(219) 703-6854
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71013562A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300072979
—
IN
Enumeration date
02/08/2023
Last updated
10/27/2023
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