Basic Information
| Provider Information | |||||||||
| NPI: | 1225546070 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MILLER | ||||||||
| FirstName: | CHELSEY | ||||||||
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| Credential: | APRN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 500 W BROADWAY ST | ||||||||
| Address2: | |||||||||
| City: | MISSOULA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598024008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4063271918 | ||||||||
| FaxNumber: | 4065492246 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 W SPRUCE ST STE J | ||||||||
| Address2: | |||||||||
| City: | MISSOULA | ||||||||
| State: | MT | ||||||||
| PostalCode: | 598024047 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4063273350 | ||||||||
| FaxNumber: | 4063273355 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/15/2018 | ||||||||
| LastUpdateDate: | 06/18/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | NUR-APRN-LIC-128752 | MT | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.