MS. SHANDA RETTA MAE MILLER FNP-BC NPI 1811660822

NPI Information

NPI: 1811660822
Provider Name: MS. SHANDA RETTA MAE MILLER, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
439 MILL HILL AVE
BRIDGEPORT, CT
ZIP 06610
Phone: (203) 334-2100
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MS. Shanda Retta Mae Miller, FNP-BC is a family nurse practitioner in Bridgeport, CT with 3 years of experience. MS. Shanda Retta Mae Miller, FNP-BC NPI is 1811660822. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

439 MILL HILL AVE
BRIDGEPORT, CT
ZIP 06610-866
Phone: (203) 334-2100
Fax: (203) 333-5864

The NPI 1811660822 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/26/2021 and was last updated on 9/21/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	9965	CONNECTICUT	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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