Provider Demographics
NPI:1972377307
Name:MILLER, CHELSEY (FNP-C)
Entity type:Individual
Prefix:
First Name:CHELSEY
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:UT
Mailing Address - Zip Code:84013-1302
Mailing Address - Country:US
Mailing Address - Phone:801-367-1179
Mailing Address - Fax:
Practice Address - Street 1:1575 W 7000 S FL 1
Practice Address - Street 2:
Practice Address - City:WEST JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84084-3431
Practice Address - Country:US
Practice Address - Phone:801-569-9133
Practice Address - Fax:801-569-9103
Is Sole Proprietor?:No
Enumeration Date:2023-11-07
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT10643473-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily