Individual provider Active NPI

Nicole Annee Miller, CRNA

  • Certified Registered Nurse Anesthetist
  • Mandeville, LA
National Provider Identifier
1649743063
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
RN137829 Issued in LA
Practice address
200 Greenleaves Blvd
Mandeville, LA 70448-7018
Phone
(855) 300-7525
NPI assigned
Jan 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN137829 LA Primary
Certified Registered Nurse Anesthetist 367500000X 202431 LA

Addresses

Primary practice location

200 Greenleaves Blvd
Mandeville, LA 70448-7018

Mailing address

109 Magnolia Cir
Natchitoches, LA 71457-5260
Phone (337) 366-7636

Other practice location 1

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2574

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190219000788 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 8628316569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians

Practice addresses (Care Compare)

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
202431LAMDPediatrics Physician
RN137829LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 21, 2019 Accepting new patients

Locations

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

1105 Kaliste Saloom Rd
Lafayette, LA 70508
Phone (225) 296-0041

200 Greenleaves Blvd
Mandeville, LA 70448
Phone (855) 300-7525

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1649743063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 MAGNOLIA CIR",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714575260",
            "telephone_number": "337-366-7636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GREENLEAVES BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487018",
            "telephone_number": "855-300-7525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Ambassador Caffery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705086917",
            "country_code": "US",
            "telephone_number": "337-470-2574",
            "fax_number": "337-470-2605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICOLE",
        "middle_name": "ANNEE",
        "name_prefix": "Miss",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-08",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN137829",
            "primary": true
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "202431",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.