Theresa Miiller, CNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

CP001603 Issued in SD

Practice address

1900 Grassland Dr
Mitchell, SD 57301-6205

Phone

(605) 995-7000

NPI assigned

Jul 19, 2019

Last updated

Jul 19, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Certified Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: tessa.miiller@avera.sdhealthlink.net

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1563494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563494400000",
    "number": "1033762984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 GRASSLAND DR",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573016205",
            "telephone_number": "605-995-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 GRASSLAND DR",
            "city": "MITCHELL",
            "state": "SD",
            "postal_code": "573016205",
            "telephone_number": "605-995-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIILLER",
        "first_name": "THERESA",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-19",
        "last_updated": "2019-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "SD",
            "license": "CP001603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan James Mentele, DPT
• Gary E Mentzel, PT
• Mga Lab Inc
• Michael E Peterson MD PC
• Mid Dakota Podiatry
• Kelley Lynn Millione, LPC
• Jai Mimmack
• Paul R Miskimins, DDS
• Mitchell Anesthesia PC
• Mitchell Bone and Joint Surgery

• Pediatric Nurse Practitioner in Mitchell, SD
• Providers in Mitchell, SD by specialty
• Pediatric Nurse Practitioner in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.