Healthcare Provider Details

I. General information

NPI: 1689766958
Provider Name (Legal Business Name): STUART DAVID MILAN PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2655 LAKELAND DR
FLOWOOD MS
39232-9516
US

IV. Provider business mailing address

48 MEDICAL PARK DR E STE 453
BIRMINGHAM AL
35235-3472
US

V. Phone/Fax

Practice location:
  • Phone: 601-957-7343
  • Fax: 601-957-7344
Mailing address:
  • Phone: 951-463-8919
  • Fax: 205-848-2227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number850823
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: