Healthcare Provider Details

I. General information

NPI: 1023693231
Provider Name (Legal Business Name): NELL MILLING
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2021
Last Update Date: 12/09/2021
Certification Date: 12/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 S UNIVERSITY BLVD, UNIT 6000
MOBILE AL
36608
US

IV. Provider business mailing address

PO BOX 746450
ATLANTA GA
30374-6450
US

V. Phone/Fax

Practice location:
  • Phone: 251-660-5555
  • Fax: 251-660-5559
Mailing address:
  • Phone: 251-434-3626
  • Fax: 251-445-2464

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA.1806
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: