Provider Demographics
NPI:1316780505
Name:MILLER, RAEGAN D (FNP-C, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:RAEGAN
Middle Name:D
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP-C, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1861 STATE HIGHWAY 276
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-9301
Mailing Address - Country:US
Mailing Address - Phone:972-722-4992
Mailing Address - Fax:
Practice Address - Street 1:1861 STATE HIGHWAY 276
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-9301
Practice Address - Country:US
Practice Address - Phone:972-722-4992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-15
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1165942363LP0808X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health