Provider Demographics
NPI:1285803767
Name:MILLER, NANCY THERESE (MD)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:THERESE
Last Name:MILLER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:11 MANITOBA RD
Mailing Address - Street 2:
Mailing Address - City:HOPKINS
Mailing Address - State:MN
Mailing Address - Zip Code:55305-4421
Mailing Address - Country:US
Mailing Address - Phone:952-944-3217
Mailing Address - Fax:952-944-3217
Practice Address - Street 1:821 3RD AVE SE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55904-7340
Practice Address - Country:US
Practice Address - Phone:763-535-9601
Practice Address - Fax:763-535-5601
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2016-06-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN35290302F00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No302F00000XManaged Care OrganizationsExclusive Provider Organization