Kellie Brooke Miralles

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

39497 Issued in TN

Practice address

1751 W Morris Blvd Ste 3
Morristown, TN 37813-3870

Phone

(423) 839-0036

NPI assigned

Nov 6, 2025

Last updated

Nov 6, 2025By 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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Omega Medical and Aesthetics PLLC

  • Family Nurse Practitioner
  • Mooresburg, TN
  • NPI 1578447181
  NPD

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

{
    "created_epoch": "1762387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1346110160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 CLAIRE PL",
            "city": "TALBOTT",
            "state": "TN",
            "postal_code": "378771704",
            "telephone_number": "865-307-5271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1751 W MORRIS BLVD STE 3",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378133870",
            "telephone_number": "423-839-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRALLES",
        "first_name": "KELLIE",
        "middle_name": "BROOKE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-06",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "39497",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Misty Michelle Mink
• Boyd Michael Minnich, PT
• Ryan Minnick, PHARMD
• McKenzie Minton, BCBA
• Jill Minx, OTR/L
• Reinaldo Felix Miralles
• Heather Nicole Mischlich, CNM
• David Mitchell, PHARMD
• Abdelrahman H Mohamed, MD
• Pascha Moles

• Family Nurse Practitioner in Morristown, TN
• Providers in Morristown, TN by specialty
• Family Nurse Practitioner in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.