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NPI Code Detail

MEDICARE: ELIZABETH T MILLAN P.N.P.

MEDICARE: ELIZABETH T MILLAN P.N.P.
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
1363LP0200XPediatric Nurse Practitioner201350012NPOR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1255662953
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH T MILLAN P.N.P.
Provider Business Mailing Address
First Line : 600 SW COLUMBIA ST STE 6210
Second Line :
City : BEND
State : OR
Zip : 97702-1099
Country : US
Telephone Number : 541-383-3005
Fax Number : 541-383-1883
Provider Business Practice Location Address
First Line : 2150 NE DAGGETT LN
Second Line :
City : BEND
State : OR
Zip : 97701-6560
Country : US
Telephone Number : 541-323-3850
Fax Number : 541-383-1883
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2010
Last Update Date : 07/21/2022

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