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NPI Code Detail

MEDICARE: MS. CAROL SUSAN MILLAN A.P.N.C.

MEDICARE: MS. CAROL SUSAN MILLAN A.P.N.C.
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
1363LF0000XFamily Nurse Practitioner26NN04569300NJ

General Provider Information

NPI Number : 1205057890
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CAROL SUSAN MILLAN A.P.N.C.
Provider Business Mailing Address
First Line : 1090 CRANSTON ST
Second Line :
City : CRANSTON
State : RI
Zip : 02920-7323
Country : US
Telephone Number : 401-943-1981
Fax Number : 401-943-2846
Provider Business Practice Location Address
First Line : 1090 CRANSTON ST
Second Line :
City : CRANSTON
State : RI
Zip : 02920-7323
Country : US
Telephone Number : 401-943-1981
Fax Number : 401-943-2846
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2007
Last Update Date : 01/14/2015

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Directions to “ MS. CAROL SUSAN MILLAN A.P.N.C.” Practice Location

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