Healthcare Provider Details

I. General information

NPI: 1366489239
Provider Name (Legal Business Name): ROSALYN PATRICIA MILTON CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 VETERANS AVE
BILOXI MS
39531-2410
US

IV. Provider business mailing address

6608 OLD DOBBIN DR N
MOBILE AL
36695-3744
US

V. Phone/Fax

Practice location:
  • Phone: 228-523-5000
  • Fax:
Mailing address:
  • Phone: 251-666-2268
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberRN030727
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: