Kelly Teresa Miller, PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

5008017 Issued in NC

Practice address

10420 Park Rd Ste 300
Charlotte, NC 28210-8502

Phone

(980) 237-4766

NPI assigned

Sep 23, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H9678

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

{
    "created_epoch": "1442966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1215306956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 PRESCOTT GLEN PKWY",
            "city": "WAXHAW",
            "state": "NC",
            "postal_code": "281736931",
            "telephone_number": "704-641-4885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 PARK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282108502",
            "telephone_number": "980-237-4766"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10440 Park Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282108544",
            "country_code": "US",
            "telephone_number": "980-237-4766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KELLY",
        "middle_name": "TERESA",
        "name_prefix": "Mrs.",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-09-23",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5008017",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NC",
            "license": "5008017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Sue Miller
• Kate K Miller, MD
• Katherine Scott Miller
• Kathryn Elizabeth Miller, PSYCHOLOGIST
• Kelly A Miller
• Kelsey Dawn Miller
• Keyadd Miller, LCSWA
• Kimberly Miller, PT, DPT
• Kimberly Diane Miller, AU.D.
• Kurt Miller

• Psychiatric/Mental Health Nurse Practitioner in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Psychiatric/Mental Health Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.