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General NPI Number Information
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NPI Number | 1063197770
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Entity Type | Individual
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Provider Name | MADISON MILAM
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Gender | Female
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Dates
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Enumeration Date | 06/20/2023
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Last Update Date | 12/19/2025
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Provider Practice Location Address
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Address Line | 1801 ASHLEY CIR
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3362
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Country | US
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Telephone | 270-793-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 ASHLEY CIR
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3362
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Country | US
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Telephone | 270-793-1000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 1145120
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 157377
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License Number State | KY
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