Healthcare Provider Details

I. General information

NPI: 1730849589
Provider Name (Legal Business Name): MILAN KAREN AGNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 SHIPYARD BLVD
WILMINGTON NC
28412-6492
US

IV. Provider business mailing address

615 SHIPYARD BLVD
WILMINGTON NC
28412-6431
US

V. Phone/Fax

Practice location:
  • Phone: 910-202-3860
  • Fax:
Mailing address:
  • Phone: 910-343-0145
  • Fax: 910-202-9966

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number5015510
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5015510
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number5015510
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: