Judith Barbara Miller, RN

Individual provider Active NPI Registered Nurse · Jackson, WI

NPI 1104952597 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1104952597
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
80525030 (WI)
Practice address
3114 Sherman Parc Circle
Jackson, WI 53037
Phone
(262) 677-8521
NPI assigned
Feb 27, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
80525030WIMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 80525030 WI Yes

Addresses

Primary practice location

3114 Sherman Parc Circle
Jackson, WI 53037

Mailing address

6339 Glen CT
West Bend, WI 53095-9112
Phone (262) 629-5389

Other identifiers

IdentifierTypeStateIssuer
39833500MedicaidWI

Other names

  • Miss Judith Barbara Hecker Other name

Other providers in Jackson, WI

All providers in Jackson, WI · Registered Nurse in Wisconsin

Sources for this page

Verify at the official NPI Registry.