Provider Demographics
NPI:1174357792
Name:MILLER, ANGELA JOY (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:JOY
Last Name:MILLER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 EDWARDS ST
Mailing Address - Street 2:
Mailing Address - City:FORT NOVOSEL
Mailing Address - State:AL
Mailing Address - Zip Code:36362-2220
Mailing Address - Country:US
Mailing Address - Phone:516-840-0159
Mailing Address - Fax:
Practice Address - Street 1:461 21ST AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37240-1104
Practice Address - Country:US
Practice Address - Phone:615-322-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-27
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY976214163W00000X
TN274367163W00000X
TN37219363LP0808X
NY406910363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse