Active NPI
Nancy Miller, ACNP
- Pediatric Nurse Practitioner
- Marietta, GA
National Provider Identifier
1407965387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Nurse Practitioner
- License
- R089642
- Practice address
- 55 Whitcher St NE
Suite 160
Marietta, GA 30060-1155 - Phone
- (770) 542-2137
- NPI assigned
- Aug 30, 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 |
|---|---|---|---|---|
| Pediatric Nurse Practitioner | 363LP0200X | R089642 | GA | Primary |
Addresses
Primary practice location
55 Whitcher St NE
Suite 160
Marietta, GA 30060-1155
Mailing address
55 Whitcher St NE
Suite 160
Marietta, GA 30060-1155
Phone (770) 422-1372
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00744158C | Medicaid | GA |
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
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R089642 | GA | MD | Pediatric Nurse Practitioner |
Interoperability endpoints
- nmiller116082@directwellstar.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456963200000",
"number": "1407965387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 WHITCHER ST NE",
"address_2": "SUITE 160",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601155",
"telephone_number": "770-422-1372"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 WHITCHER ST NE",
"address_2": "SUITE 160",
"city": "MARIETTA",
"state": "GA",
"postal_code": "300601155",
"telephone_number": "770-542-2137"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "NANCY",
"name_prefix": "Ms.",
"credential": "ACNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2016-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Pediatrics",
"state": "GA",
"license": "R089642",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00744158C",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marietta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.