Individual provider Active NPI

Nichole Miller, RN, NNP

  • Neonatal Nurse Practitioner
  • Minneapolis, MN
National Provider Identifier
1881831279
Registry record updated Jan 7, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal Nurse PractitionerTaxonomy code 363LN0000X
License
R 169787-8 Issued in MN
Practice address
2450 Riverside Ave
Minneapolis, MN 55454-1450
Phone
(612) 273-7032
NPI assigned
Jan 7, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal Nurse Practitioner 363LN0000X R 169787-8 MN Primary

Addresses

Primary practice location

2450 Riverside Ave
Minneapolis, MN 55454-1450

Mailing address

1861 Michael Point Dr
Eagan, MN 55122-2463
Phone (651) 686-4769

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20091110000188 MN Practitioner - Nurse Practitioner 7113065368 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R 169787-8MNMDNeonatal Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Health Services Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: nmiller191289@fairview.direct-ci.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1231286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231286400000",
    "number": "1881831279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 MICHAEL POINT DR",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222463",
            "telephone_number": "651-686-4769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 RIVERSIDE AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554541450",
            "telephone_number": "612-273-7032"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "NICHOLE",
        "credential": "RN, NNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-07",
        "last_updated": "2009-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LN0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Neonatal",
            "state": "MN",
            "license": "R 169787-8",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.