Healthcare Provider Details

I. General information

NPI: 1578725669
Provider Name (Legal Business Name): KATHERINE JANE MILLEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 01/25/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 OLENTANGY RIVER RD FL 1
COLUMBUS OH
43214-3908
US

IV. Provider business mailing address

5400 FRANTZ RD STE 250
DUBLIN OH
43016-6102
US

V. Phone/Fax

Practice location:
  • Phone: 614-566-4378
  • Fax: 614-566-6904
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number01075807A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number01075807A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number35.098854
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: