Provider Demographics
NPI:1104473842
Name:MILLER, ASHLEY RENEE (FNP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:RENEE
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-1434
Mailing Address - Country:US
Mailing Address - Phone:317-773-0760
Mailing Address - Fax:
Practice Address - Street 1:865 WESTFIELD RD STE D
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-8938
Practice Address - Country:US
Practice Address - Phone:317-776-3851
Practice Address - Fax:317-776-3854
Is Sole Proprietor?:No
Enumeration Date:2019-08-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5012168363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily