Kathy Miller, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

082964 Issued in MO

Practice address

2024 Dorsett VLG
Maryland Heights, MO 63043-2208

Phone

(314) 590-0550

Fax

(314) 590-0560

NPI assigned

Apr 20, 2010

Last updated

Apr 20, 2010By 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271721600000",
    "number": "1780900456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 WALL ST",
            "address_2": "SUITE 310",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633033539",
            "telephone_number": "636-669-2268",
            "fax_number": "314-209-8127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2024 DORSETT VLG",
            "city": "MARYLAND HEIGHTS",
            "state": "MO",
            "postal_code": "630432208",
            "telephone_number": "314-590-0550",
            "fax_number": "314-590-0560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "KATHY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2010-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "082964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "082964",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nancy Paulk Mobley, LPC
• Ian Lei Modde, PT, DPT
• Rashid Muhammad, MA; LCPC-IL; LPC-MO

• Family Nurse Practitioner in Maryland Heights, MO
• Providers in Maryland Heights, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2010; 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.