| Nicole Miller, Pmhnp-bc, Llc | |
|
907 Mar Walt Dr Fort Walton Beach FL 32547-6960 | |
| (850) 781-3185 | |
| Not Available |
| Full Name | Nicole Miller, Pmhnp-bc, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 907 Mar Walt Dr, Fort Walton Beach, Florida |
| Authorized Official Name and Position | Nicole Miller (NURSE PRACTITIONER) |
| Authorized Official Contact | 2673310660 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nicole Miller, Pmhnp-bc, Llc 2200 Siros Ct Navarre FL 32566-4181 Ph: (267) 331-0660 | Nicole Miller, Pmhnp-bc, Llc 907 Mar Walt Dr Fort Walton Beach FL 32547-6960 Ph: (850) 781-3185 |
| NPI Number | 1184381790 |
|---|---|
| Provider Enumeration Date | 11/18/2021 |
| Last Update Date | 11/18/2021 |
| Certification Date | 11/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184381790 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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