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NPI Code Detail

MEDICARE: MRS. ELLEN MARIE MILBERGER APRN

MEDICARE: MRS. ELLEN MARIE MILBERGER APRN
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 PractitionerRN125880GA

General Provider Information

NPI Number : 1265781116
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ELLEN MARIE MILBERGER APRN
Provider Business Mailing Address
First Line : 3523 DUNN ST.
Second Line :
City : SMYRNA
State : GA
Zip : 30080
Country : US
Telephone Number : 678-472-4379
Fax Number :
Provider Business Practice Location Address
First Line : 800 E WEST CONNECTOR
Second Line :
City : AUSTELL
State : GA
Zip : 30106-1358
Country : US
Telephone Number : 770-438-1680
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2012
Last Update Date : 09/27/2019

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