Whitney Victoria Miller, FNP-C
Individual provider Active NPI Nurse Practitioner · Bridgeport, TX
NPI 1477830792 · NPPES record last updated Apr 30, 2019
Key facts
- NPI
- 1477830792
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 121149 (TX)
- Practice address
- 2202 US Highway 380
Suite #112
Bridgeport, TX 76426-2176 - Phone
- (940) 683-2338
- Fax
- (940) 683-2394
- NPI assigned
- Nov 15, 2011
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120608000139 | TX | Practitioner - Nurse Practitioner | 0446414122 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science - Nursing
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wise Clinical Care Associates | Nurse Practitioner | Current |
Accepting new patients |
| Wise Clinical Care Associates | Past | Accepting new patients |
Locations
133 N FM 730
Unit 105
Boyd, TX 76023
Phone (940) 433-2151
2202 US Highway 380
Ste 112
Bridgeport, TX 76426
Phone (940) 683-2338
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 121149 | TX | Yes |
Addresses
Primary practice location
2202 US Highway 380
Suite #112
Bridgeport, TX 76426-2176
Mailing address
PO Box 2078
Decatur, TX 76234-6156
Phone (940) 683-2338
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 872N48 | Other | TX | BCBS |
| 298999801 | Medicaid | TX |
Other providers in Bridgeport, TX
- Jacob Mayberry
- Timothy W McIntyre
- Christine Rene Meredith
- Noemi Araceli Meza
- Michael a. Basco M.D. PA
- Michael A Millis
- Linda Sue Montgomery
- Anna Leigh Morgan
- William Newsom
- Brenda Norwood
All providers in Bridgeport, TX · Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 30, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.