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General NPI Number Information
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NPI Number | 1205205515
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Entity Type | Organization
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Legal Business Name | MILESTONE CREATIONS
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Dates
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Enumeration Date | 09/16/2015
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Last Update Date | 09/16/2015
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Provider Practice Location Address
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Address Line | 159 MINNESOTA AVE
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City | ROSEVILLE
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State | MN
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Zip | 55113-4703
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Country | US
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Telephone | 612-558-9453
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Fax |
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Provider Business Mailing Address
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Address Line | 159 MINNESOTA AVE
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City | ROSEVILLE
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State | MN
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Zip | 55113-4703
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DOULA
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Name | SIERRA LEONE WILLIAMS
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Credential |
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Telephone | 612-558-9453
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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