Healthcare Provider Details

I. General information

NPI: 1891355970
Provider Name (Legal Business Name): TAQUITA MILNER NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2019
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7490 WATERSIDE CROSSING BLVD STE 2A
DENVER NC
28037-3004
US

IV. Provider business mailing address

7490 WATERSIDE CROSSING BLVD STE 2A
DENVER NC
28037-3004
US

V. Phone/Fax

Practice location:
  • Phone: 980-800-9380
  • Fax:
Mailing address:
  • Phone:
  • Fax: 704-270-6140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5014419
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2018037020
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: