Jacqueline Mary Miller, MSN,ANP-C
Individual provider Active NPI Primary Care Nurse Practitioner · Edgartown, MA
NPI 1699009787 · NPPES record last updated Sep 23, 2009
Key facts
- NPI
- 1699009787
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Primary Care Nurse Practitioner 363LP2300X
- License
- 213927 (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
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Certified Nurse Practitioner, Master of Science - Nursing
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213927 | MA | MD | Primary Care Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Primary Care Nurse Practitioner | 363LP2300X | 213927 | MA | Yes |
Addresses
Primary practice location
245 Edgartown- Vineyard Haven Road
Island Health Care
Edgartown, MA 02539
Mailing address
245 Vineyard Haven -Edgartown Road
P.O Box 9000
Edgartown, MA 02539
Phone (508) 939-9358
Other providers in Edgartown, MA
- Harold F Lynch
- Deborah Joan Magiera
- Main Street Dental
- Julianne Maxwell
- Susan Marie McSweeney
- Elizabeth A. Moriarty
- Claudette Irene Mullen
- Alyssa Murray
- MV Occupational Therapy LLC
- Elizabeth Owens
All providers in Edgartown, MA · Primary Care Nurse Practitioner in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.