| Whitney Victoria Miller, FNP-C | |
|
2202 Us Highway 380, Suite #112, Bridgeport, TX 76426-2176 | |
| (940) 683-2338 | |
| (940) 683-2394 |
| Full Name | Whitney Victoria Miller |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Location | 2202 Us Highway 380, Bridgeport, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477830792 | NPI | - | NPPES |
| 872N48 | Other | TX | BCBS |
| 298999801 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 121149 (Texas) | Primary |
| Entity Name | Wise Clinical Care Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1679719801 PECOS PAC ID: 6204988975 Enrollment ID: O20090710000550 |
| Mailing Address | Practice Location Address |
|---|---|
| Whitney Victoria Miller, FNP-C Po Box 2078, Decatur, TX 76234-6156 Ph: (940) 683-2338 | Whitney Victoria Miller, FNP-C 2202 Us Highway 380, Suite #112, Bridgeport, TX 76426-2176 Ph: (940) 683-2338 |
Leisha Monette Blaylock, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2202 Us Highway 380, Suite 112, Bridgeport, TX 76426 Phone: 940-683-2338 Fax: 940-683-2394 | |
Kaye Puckett, DNP, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2202 Us Highway 380 Ste 112, Bridgeport, TX 76426 Phone: 940-683-2338 Fax: 940-683-2394 | |
Mr. Alexander Lee Pendergrass, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 808 Woodrow Wilson Ray Cir, Bridgeport, TX 76426 Phone: 817-966-2960 |