MEDICARE: CASSANDRA MILLIGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	311ZA0620X	Adult Care Home Facility	0018951	WI

General Provider Information

NPI Number	:	1013608199
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CASSANDRA MILLIGAN

Provider Business Mailing Address
First Line	:	7874 W PALMETTO AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-3750
Country	:	US
Telephone Number	:	414-249-4042
Fax Number	:

Provider Business Practice Location Address
First Line	:	7874 W PALMETTO AVE
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53218-3750
Country	:	US
Telephone Number	:	414-249-4042
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/18/2023
Last Update Date	:	05/18/2023

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Directions to “ CASSANDRA MILLIGAN ” Practice Location

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