MEDICARE: LYNNELLE MILNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225X00000X	Occupational Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0134	OTHER	NV	LICENSE #

General Provider Information

NPI Number	:	1912083510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNELLE MILNER

Provider Business Mailing Address
First Line	:	7285 FALLING TIMBER CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89113-1136
Country	:	US
Telephone Number	:	702-367-6622
Fax Number	:

Provider Business Practice Location Address
First Line	:	6330 SPRING MOUNTAIN RD STE E
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-8843
Country	:	US
Telephone Number	:	702-228-4559
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/27/2006
Last Update Date	:	07/08/2007

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Directions to “ LYNNELLE MILNER ” Practice Location

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