Jacqueline Mary Miller, MSN,ANP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

213927 Issued in MA

Practice address

245 Edgartown- Vineyard Haven Road
Island Health Care
Edgartown, MA 02539

Phone

(508) 939-9358

Fax

(508) 939-8644

NPI assigned

Sep 23, 2009

Last updated

Sep 23, 2009By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1253664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1253664000000",
    "number": "1699009787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 VINEYARD HAVEN -EDGARTOWN ROAD",
            "address_2": "P.O BOX 9000",
            "city": "EDGARTOWN",
            "state": "MA",
            "postal_code": "02539",
            "telephone_number": "508-939-9358",
            "fax_number": "508-939-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 EDGARTOWN- VINEYARD HAVEN ROAD",
            "address_2": "ISLAND HEALTH CARE",
            "city": "EDGARTOWN",
            "state": "MA",
            "postal_code": "02539",
            "telephone_number": "508-939-9358",
            "fax_number": "508-939-8644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "JACQUELINE",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "MSN,ANP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-23",
        "last_updated": "2009-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "213927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Nurse Practitioner in Edgartown, MA
• Providers in Edgartown, MA by specialty
• Primary Care Nurse Practitioner in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.