Individual provider Active NPI

Brandi Lee Miller, CRNP

  • Nurse Practitioner
  • State College, PA
National Provider Identifier
1770313462
Registry record updated Apr 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
SP030311 Issued in PA
Practice address
155 Wellness Way
State College, PA 16803
Phone
(814) 231-7000
NPI assigned
Aug 6, 2024
Last updated
Apr 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X SP030311 PA Primary

Addresses

Primary practice location

155 Wellness Way
State College, PA 16803

Mailing address

615 Wright St
Lock Haven, PA 17745-3113
Phone (570) 295-8453

Other practice location 1

1001 Pine St
Renovo, PA 17764-1620
Phone (570) 923-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20250319002978 PA Practitioner - Nurse Practitioner 1951823962 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Centre Emergency Medical Associates, PC.Group PAC ID 3375529183, 6 clinicians

Practice addresses (Care Compare)

155 Wellness Way
State College, PA 16803-6702
Phone (800) 367-0179

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
SP030311PAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Bucktail Medical Center CurrentSince Feb 22, 2025 Accepting new patients
Centre Emergency Medical Associates, PC. Emergency Medicine CurrentSince Mar 15, 2025 Accepting new patients
Bucktail Medical Center CurrentSince Feb 22, 2025 Accepting new patients

Locations

1001 Pine St
Renovo, PA 17764
Phone (570) 923-1000

155 Wellness Way
State College, PA 16803
Phone (800) 367-0179

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1722902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744329600000",
    "number": "1770313462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 WRIGHT ST",
            "city": "LOCK HAVEN",
            "state": "PA",
            "postal_code": "177453113",
            "telephone_number": "570-295-8453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 WELLNESS WAY",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "16803",
            "telephone_number": "814-231-7000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1001 Pine St",
            "address_purpose": "LOCATION",
            "city": "Renovo",
            "state": "PA",
            "postal_code": "177641620",
            "country_code": "US",
            "telephone_number": "570-923-1001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MILLER",
        "first_name": "BRANDI",
        "middle_name": "LEE",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-06",
        "last_updated": "2025-04-11",
        "certification_date": "2025-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "PA",
            "license": "SP030311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in State College, PA

Sources for this page

Verify at the official NPI Registry.