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NPI Code Detail

MEDICARE: CHRISTY ANN MILAM

MEDICARE: CHRISTY ANN MILAM
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
1163W00000XRegistered NurseR0078884 D6248676OK

General Provider Information

NPI Number : 1104153295
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTY ANN MILAM
Provider Business Mailing Address
First Line : PO BOX 104
Second Line :
City : ANTLERS
State : OK
Zip : 74523-0104
Country : US
Telephone Number : 580-271-0193
Fax Number : 580-298-5072
Provider Business Practice Location Address
First Line : 608 HIGHWAY 271 N
Second Line :
City : ANTLERS
State : OK
Zip : 74523-2055
Country : US
Telephone Number : 580-298-5062
Fax Number : 580-298-5072
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2009
Last Update Date : 11/10/2009

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Directions to “ CHRISTY ANN MILAM ” Practice Location

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