Healthcare Provider Details

I. General information

NPI: 1982075164
Provider Name (Legal Business Name): LYNDSEY L MILAM APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2015
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MAIN ST W
OAK HILL WV
25901-2943
US

IV. Provider business mailing address

121 MAIN ST W
OAK HILL WV
25901-2943
US

V. Phone/Fax

Practice location:
  • Phone: 304-465-6611
  • Fax:
Mailing address:
  • Phone: 304-465-6611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number75601
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: