Individual provider Active NPI

Andrea Sue Miller, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Okemos, MI
National Provider Identifier
1629418041
Registry record updated Nov 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704255922 Issued in MI
Practice address
4211 Okemos Rd Ste 12
Okemos, MI 48864-3287
Phone
(517) 214-9779
Fax
(517) 201-0607
NPI assigned
Jun 29, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704255922 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704255922 MI Primary

Addresses

Primary practice location

4211 Okemos Rd Ste 12
Okemos, MI 48864-3287

Mailing address

4211 Okemos Rd Ste 12
Okemos, MI 48864-3287

Other identifiers 1

IdentifierTypeStateIssuer
1629418041MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20131017001776 MI Practitioner - Nurse Practitioner 6103050547 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704255922MIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Miller Mental Health Staffing CurrentSince Jul 22, 2025 Accepting new patients
Memorial Hospital Family Past Accepting new patients

Locations

4211 Okemos Rd
Ste 12
Okemos, MI 48864
Phone (517) 214-9779

Interoperability endpoints

  • Direct secure messaging: amiller@yourcarecommunity.org

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1372464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763769600000",
    "number": "1629418041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4211 OKEMOS RD STE 12",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643287",
            "fax_number": "517-201-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4211 OKEMOS RD STE 12",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488643287",
            "telephone_number": "517-214-9779",
            "fax_number": "517-201-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "ANDREA",
        "middle_name": "SUE",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-29",
        "last_updated": "2025-11-22",
        "certification_date": "2025-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704255922",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704255922",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629418041",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.