Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Malissa Miller, NURSEPRACTITIONER

Individual provider Family Nurse Practitioner · NPI 1285113217

Malissa Miller, NURSEPRACTITIONER is a Nurse Practitioner in Columbia, Illinois. Qualified in 2018, 8 years ago. Practices with My Mobile MD Illinois LLC, a 5-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Illinois.

Years since qualifying
8
Licensed in
IL
In the registry since
2018
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Practice location Address checks out

107 N Main St Ste 2A
Columbia, IL 62236-1757
Phone: (618) 693-9313
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2070 McKelvey Rd, Maryland Heights, MO 63043-2308 — (314) 434-1900

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 277002437 (IL)

Record details

NPI number1285113217
Entity typeIndividual (Type 1)
GenderFemale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedAugust 10, 2018
Last updated in NPPESNovember 28, 2023
Certification dateNovember 28, 2023
Mailing address107 N Main St Ste 2a, Columbia, IL 62236-1757

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice My Mobile Md Illinois Llc — 5 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Columbia