Healthcare Provider Details

I. General information

NPI: 1891609962
Provider Name (Legal Business Name): EMILY ANN MILICH FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2026
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-1200 KEAUNUI DR APT 204
EWA BEACH HI
96706-5600
US

IV. Provider business mailing address

91-1200 KEAUNUI DR APT 204
EWA BEACH HI
96706-5600
US

V. Phone/Fax

Practice location:
  • Phone: 330-417-4838
  • Fax:
Mailing address:
  • Phone: 330-417-4838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF09261075
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: