Katherine Ann Miller, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95017731 Issued in CA

Practice address

652 Petaluma Ave Ste H
Sebastopol, CA 95472-4266

Phone

(707) 823-3166

NPI assigned

Jul 13, 2021

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

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: katherine.miller@wchealth.eclinicaldirectplus.com

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1346812914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7424 MITCHELL DR",
            "city": "ROHNERT PARK",
            "state": "CA",
            "postal_code": "949283634",
            "telephone_number": "530-386-6575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "652 PETALUMA AVE STE H",
            "city": "SEBASTOPOL",
            "state": "CA",
            "postal_code": "954724266",
            "telephone_number": "707-823-3166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KATHERINE",
        "middle_name": "ANN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95017731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steve C Mertens, MD
• Tara Metcalf, LMFT
• Michael T. Bollinger, MD, a Professional Corporation
• Cammy Anne Michel, PSY 24688
• Constance Iha Miles, LM CPM RN
• Marlys Miller, RRT
• Michelle Anne Miller, LCSW
• Trevor Ross Miller, D.C.
• Roberta Latefa Mineo, PHD
• Norman Jay Mintz, O.D.

• Family Nurse Practitioner in Sebastopol, CA
• Providers in Sebastopol, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.