MEDICARE: SANDRA J MILNER ARNP

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	363L00000X	Nurse Practitioner	ARNP9280300	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1346572401
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SANDRA J MILNER ARNP

Provider Business Mailing Address
First Line	:	PO BOX 606
Second Line	:
City	:	GLEN ST MARY
State	:	FL
Zip	:	32040-0606
Country	:	US
Telephone Number	:	904-653-1818
Fax Number	:	904-653-1814

Provider Business Practice Location Address
First Line	:	319 W CALL ST
Second Line	:	SUITE B
City	:	STARKE
State	:	FL
Zip	:	32091-3113
Country	:	US
Telephone Number	:	904-966-0000
Fax Number	:	904-966-0009

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

Provider Enumeration Date	:	02/01/2010
Last Update Date	:	04/28/2010

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