Active NPI
Elaine Marie Miller, CNP
- Family Nurse Practitioner
- Mankato, MN
National Provider Identifier
1295811792
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- R 073230-7
- Practice address
- 1230 E Main St
Mankato, MN 56001-5066 - Phone
- (507) 625-1811
- NPI assigned
- Oct 27, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | R 073230-7 | MN | Primary |
Addresses
Primary practice location
1230 E Main St
Mankato, MN 56001-5066
Mailing address
5506 N Shore CT
Madison Lake, MN 56063-9521
Phone (507) 934-2207
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 562312000 | Medicaid | MN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R 073230-7 | MN | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161907200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1292371200000",
"number": "1295811792",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5506 N SHORE CT",
"city": "MADISON LAKE",
"state": "MN",
"postal_code": "560639521",
"telephone_number": "507-934-2207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1230 E MAIN ST",
"city": "MANKATO",
"state": "MN",
"postal_code": "560015066",
"telephone_number": "507-625-1811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "ELAINE",
"middle_name": "MARIE",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-27",
"last_updated": "2010-12-15",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MN",
"license": "R 073230-7",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "562312000",
"state": "MN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mankato, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.