Active NPI
Jessica L Miller
- Registered Nurse
- Malone, WI
National Provider Identifier
1902135023
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 166830-030
- Practice address
- W4054 Linden Dr
Malone, WI 53049-1694 - Phone
- (920) 921-1404
- NPI assigned
- Dec 19, 2009
- Last updated
- Sep 15, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 166830-030 | WI | Primary |
Addresses
Primary practice location
W4054 Linden Dr
Malone, WI 53049-1694
Mailing address
2235 Brookview CT
Unit D
Oshkosh, WI 54904-7851
Phone (920) 606-6657
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 166830-030 | WI | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1261180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316044800000",
"number": "1902135023",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2235 BROOKVIEW CT",
"address_2": "UNIT D",
"city": "OSHKOSH",
"state": "WI",
"postal_code": "549047851",
"telephone_number": "920-606-6657"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "W4054 LINDEN DR",
"city": "MALONE",
"state": "WI",
"postal_code": "530491694",
"telephone_number": "920-921-1404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "JESSICA",
"middle_name": "L",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-12-19",
"last_updated": "2011-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "WI",
"license": "166830-030",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Malone, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.