Provider Demographics
NPI:1104124502
Name:MILLER, TOBY LEA (APRN-CNP)
Entity type:Individual
Prefix:
First Name:TOBY
Middle Name:LEA
Last Name:MILLER
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1603 W 9TH AVE
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-5202
Mailing Address - Country:US
Mailing Address - Phone:405-379-0002
Mailing Address - Fax:405-300-1090
Practice Address - Street 1:1603 W 9TH AVE
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-5202
Practice Address - Country:US
Practice Address - Phone:405-379-0002
Practice Address - Fax:405-300-1090
Is Sole Proprietor?:No
Enumeration Date:2011-03-09
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0067082363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health