Active NPI
Stacy Miller, NP-C
- Adult Health Nurse Practitioner
- Sheboygan, WI
National Provider Identifier
1942628623
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Adult Health Nurse Practitioner
- License
- 5730-33
- Practice address
- 1621 N Taylor Dr
Suite 100
Sheboygan, WI 53081-1990 - Phone
- (920) 459-8300
- NPI assigned
- Mar 31, 2014
- 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 |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 5730-33 | WI | Primary |
Addresses
Primary practice location
1621 N Taylor Dr
Suite 100
Sheboygan, WI 53081-1990
Mailing address
1621 N Taylor Dr
Suite 100
Sheboygan, WI 53081-1990
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)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1396224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1467763200000",
"number": "1942628623",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1621 N TAYLOR DR",
"address_2": "SUITE 100",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530811990"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1621 N TAYLOR DR",
"address_2": "SUITE 100",
"city": "SHEBOYGAN",
"state": "WI",
"postal_code": "530811990",
"telephone_number": "920-459-8300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MILLER",
"first_name": "STACY",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-03-31",
"last_updated": "2016-07-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LA2200X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Adult Health",
"state": "WI",
"license": "5730-33",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sheboygan, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.