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Clarisa G Miller

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

903 W Martin St, San Antonio, TX 78207-0903

PECOS Enrollment

This provider is enrolled in PECOS as CLARISA MILLER.

Based on the most recent information from CMS, provider Clarisa G Miller is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 9:43 AM.

Profile Details

Provider ID
1851841266
Provider Type
Individual
Full Name
Miller, Clarisa G
Credential
FNP

Gender
Female
Sole Proprietor
No
Enumeration Date
10/10/2016
Last Updated
10/2/2024

Contact Information

Practice Location

903 W Martin St, San Antonio, TX 78207-0903

(210) 358-3582

(210) 358-3252

Mailing Location

903 W Martin St, San Antonio, TX 78207-0903

(210) 358-3582

(210) 358-3252

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License AP132024 Texas

Provider Identifiers

ID	Description	Issuer
ID 364067402	Description Other	Issuer CSHCN Texas
ID 364067401	Description Medicaid	Issuer Unlisted Texas

Clarisa G Miller

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

ID

Description

Issuer

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