Individual provider · Type 1 NPI

Ty Miller, NP

Nurse Practitioner · Mount Vernon, IL

NPI number 1497681803 Active

Practice location

209 Crossroads Pl
Mount Vernon, IL 62864-6545

Call (618) 244-8100 Map

Fax (618) 241-9079

Mailing address

PO Box 632331
Cincinnati, OH 45263-2331

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X209036587 (IL)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1497681803

Ty Miller, NP's National Provider Identifier is 1497681803, issued on Jun 23, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Mount Vernon, IL. The record was last updated on Sep 16, 2026.